Neglected nonunion of phalangeal neck fractures of the thumb in children: the outcome of delayed bone grafting in adulthood.

PubMed

Al-Qattan, Mohammad M

2012-03-01

Over a 12-year period, the author treated a total of 5 adults (mean age, 23 years) with neglected nonunion of phalangeal neck fractures of the thumb that were sustained in early childhood. Cosmetically, the affected thumb was shorter and smaller than the contralateral thumb. The thumb tip was flail and thumb pinch was weak. X-rays showed a nonunited phalangeal neck fracture with no radiologic evidence of avascular necrosis of the phalangeal head. All patients underwent iliac crest bone grafting. Bone union was obtained in all patients. At final follow-up (mean, 9 months), all patients were satisfied with the cosmetic appearance of the thumb. The thumb length increased by an average of 6 mm (range, 5-8 mm). Pinch improved in the range of 69% to 87% of the power of the contralateral thumb. However, there was restricted range of motion of the interphalangeal joint (mean range of motion of 10 degree only). It was concluded that delayed bone grafting of neglected nonunions of pediatric phalangeal neck fractures of the thumb is a worthwhile procedure and has a high satisfaction rate.

Quantifying phalangeal curvature: an empirical comparison of alternative methods.

PubMed

Stern, J T; Jungers, W L; Susman, R L

1995-05-01

It has been generally assumed and theoretically argued that the curvature of finger and toe bones seen in some nonhuman primates is associated with cheiridial use in an arboreal setting. Assessment of such curvature in fossil primates has been used to infer the positional behavior of these animals. Several methods of quantifying curvature of bones have been proposed. The measure most commonly applied to phalanges is that of included angle, but this has come under some criticism. We consider various other approaches for quantifying phalangeal curvature, demonstrating that some are equivalent to use of included angle, but that one--normalized curvature moment arm (NCMA)--represents a true alternative. A comparison of NCMA to included angle, both calculated on manual and pedal proximal phalanges of humans, apes, some monkeys, and the Hadar fossils, revealed that these two different measures of curvature are highly correlated and result in very similar distributional patterns.

Towards Humanlike Social Touch for Prosthetics and Sociable Robotics: Three-Dimensional Finite Element Simulations of Synthetic Finger Phalanges

NASA Astrophysics Data System (ADS)

Cabibihan, John-John; Ge, Shuzhi Sam

Synthetic skins with humanlike characteristic would make it possible to address some of the psychosocial requirements of prosthetic hands as well as the safety and acceptance issues in social robotics. This paper describes the development of three-dimensional finite element models of synthetic finger phalanges. With the aim of duplicating the skin compliance of human finger phalanges, the model was used to investigate the effects of (i) introducing open pockets in the internal structure and (ii) combining different materials as external and internal layers. The results show that having pockets in the internal structure of the design can increase the skin compliance of the synthetic phalanges and make it comparable with the human counterpart. Moreover, having different layers can be used to satisfy skin compliance and other design requirements such as wear and tear.

Grasping primate development: Ontogeny of intrinsic hand and foot proportions in capuchin monkeys (Cebus albifrons and Sapajus apella).

PubMed

Young, Jesse W; Heard-Booth, Amber N

2016-09-01

Young primates have relatively large hands and feet for their body size, perhaps enhancing grasping ability. We test the hypothesis that selection for improved grasping ability is responsible for these scaling trends by examining the ontogeny of intrinsic hand and foot proportions in capuchin monkeys (Cebus albifrons and Sapajus apella). If selection for improved grasping ability is responsible for the observed patterns of hand and foot growth in primates, we predicted that fingers and toes would be longer early in life and proportionally decline with age. We measured the lengths of manual and pedal metapodials and phalanges in a mixed-longitudinal radiographic sample. Bone lengths were (a) converted into phalangeal indices (summed non-distal phalangeal length/metapodial length) to test for age-related changes in intrinsic proportions and (b) fit to Gompertz models of growth to test for differences in the dynamics of phalangeal versus metapodial growth. Manual and pedal phalangeal indices nearly universally decreased with age in capuchin monkeys. Growth curve analyses revealed that metapodials generally grew at a faster rate, and for a longer duration, than corresponding phalanges. Our findings are consistent with the hypothesis that primates are under selection for increased grasping ability early in life. Relatively long digits may be functionally adaptive for growing capuchins, permitting a more secure grasp on both caregivers and arboreal supports, as well as facilitating early foraging. Additional studies of primates and other mammals, as well as tests of grasping performance, are required to fully evaluate the adaptive significance of primate hand and foot growth. © 2016 Wiley Periodicals, Inc.

Metacarpal and phalangeal fractures.

PubMed

Bowman, S H; Simon, R R

1993-08-01

Metacarpal and phalangeal fractures are common presenting injuries in many emergency departments. The emergency physician should become skilled at properly evaluating and initiating appropriate management and follow-up for these injuries when they occur. Failure to properly do so may result in permanent disability.

Spool-shaped proximal pedal phalanges.

PubMed

Sutro, C J; Sutro, W H

1986-01-01

We have observed that "spool-shaped" proximal pedal phalanges sometimes are found in single or multiple toes, often affecting both feet. These changes may be present in normal as well as abnormal feet. The etiology is unknown. Such changes do not occur in the hands.

Long-term donor site morbidity after free nonvascularized toe phalangeal transfer.

PubMed

Garagnani, Lorenzo; Gibson, Marc; Smith, Paul J; Smith, Gillian D

2012-04-01

Free nonvascularized toe phalangeal transfer is an established surgical option for the reconstruction of hypoplastic digits. This study assessed long-term morbidity in the feet using this technique. We reviewed 40 children treated between 1991 and 2007 by free nonvascularized toe phalangeal transfer. The diagnosis was digital hypoplasia resulting from symbrachydactyly in 33 cases, constriction ring syndrome in 3 cases, thumb hypoplasia in 3 cases, and perinatal subclavian venous thrombosis in 1 case. The patients were followed up after surgery for a mean of 10 years (range, 3-19 y). The Oxford Ankle Foot Questionnaire was administered to patients and families to assess patient symptoms and patient and parental satisfaction. We assessed toe length ratio, the presence of visible deformity, and distal hypoplasia of the donor toes clinically and radiographically. Emotional problems related to foot appearance were common. We also found functional problems with footwear in some patients. All patients had floppy unstable toes with visible deformity. Increasing foot deformity was seen with growth, which led to deterioration in foot aesthetics, particularly where multiple donor toes had been harvested. We identified distal and middle phalangeal and metatarsal hypoplasia in the donor toes. Donor site morbidity for free toe phalangeal transfer is greater than previously documented. This should be considered during surgical decision making for reconstruction of hypoplastic digits. Preoperative counseling should include discussion regarding possible consequences of phalangeal harvest on donor toes and options for donor site reconstruction. Long-term follow-up of the donor site is essential to accurately assess results. Therapeutic III. Copyright © 2012 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Tricho-rhino-phalangeal syndrome type I in a Belgian family.

PubMed

Verbruggen, L A; Van Laere, C; Lamoureux, J; Van Tiggelen, R

1987-06-01

We report three cases of tricho-rhino-phalangeal syndrome (TRPS) type I in a Belgian family. They presented typical characteristics such as a pear-shaped nose, and short, deformed fingers with cone-shaped epiphyses of some middle phalanges of the hands. Hair growth was practically normal in our patients, except for some narrowing of the lateral part of the eyebrows. Perthes-like hip dysplasia was documented in two of our cases. The proband presented at the age of 31 with Kienböch's disease of the right wrist. Blood and urine analysis showed no clear anomalies. In this patient, echography revealed a renal cyst containing a stone. The relationship of these findings to TRPS is discussed.

Investigation of methods for estimating hand bone dimensions using X-ray hand anthropometric data.

PubMed

Kong, Yong-Ku; Freivalds, Andris; Kim, Dae-Min; Chang, Joonho

2017-06-01

This study examined two conversion methods, M1 and M2, to predict finger/phalange bone lengths based on finger/phalange surface lengths. Forty-one Korean college students (25 males and 16 females) were recruited and their finger/phalange surface lengths, bone lengths and grip strengths were measured using a vernier caliper, an X-ray generator and a double-handle force measurement system, respectively. M1 and M2 were defined as formulas able to estimate finger/phalange bone lengths based on one dimension (i.e., surface hand length) and four finger dimensions (surface finger lengths), respectively. As a result of conversion, the estimation errors by M1 presented mean 1.22 mm, which was smaller than those (1.29 mm) by M2. The bone lengths estimated by M1 (mean r = 0.81) presented higher correlations with the measured bone lengths than those estimated by M2 (0.79). Thus, the M1 method was recommended in the present study, based on conversion simplicity and accuracy.

Biomechanics of phalangeal curvature.

PubMed

Richmond, Brian G

2007-12-01

Phalangeal curvature has been widely cited in primate functional morphology and is one of the key traits in the ongoing debate about whether the locomotion of early hominins included a significant degree of arboreality. This study examines the biomechanics of phalangeal curvature using data on hand posture, muscle recruitment, and anatomical moment arms to develop a finite element (FE) model of a siamang manual proximal phalanx during suspensory grasping. Strain patterns from experiments on intact cadaver forelimbs validated the model. The strain distribution in the curved siamang phalanx FE model was compared to that in a mathematically straight rendition in order to test the hypotheses that curvature: 1) reduces strain and 2) results in lower bending strains but relatively higher compression. In the suspensory posture, joint reaction forces load the articular ends of the phalanx in compression and dorsally, while muscle forces acting through the flexor sheath pull the mid-shaft palmarly. These forces compress the phalanx dorsally and tense it palmarly, effectively bending it 'open.' Strains in the curved model were roughly half that of the straight model despite equivalent lengths, areas, mechanical properties, and loading conditions in the two models. The curved model also experienced a higher ratio of compressive to tensile strains. Curvature reduces strains during grasping hand postures because the curved bone is more closely aligned with the joint reaction forces. Therefore, phalangeal curvature reduces the strains associated with arboreal, and especially suspensory, activity involving flexed digits. These results offer a biomechanical explanation for the observed association between phalangeal curvature and arboreality.

The correspondence between proximal phalanx morphology and locomotion: implications for inferring the locomotor behavior of fossil catarrhines.

PubMed

Rein, Thomas R

2011-11-01

Phalanges are considered to be highly informative in the reconstruction of extinct primate locomotor behavior since these skeletal elements directly interact with the substrate during locomotion. Variation in shaft curvature and relative phalangeal length has been linked to differences in the degree of suspension and overall arboreal locomotor activities. Building on previous work, this study investigated these two skeletal characters in a comparative context to analyze function, while taking evolutionary relationships into account. This study examined the correspondence between proportions of suspension and overall substrate usage observed in 17 extant taxa and included angle of curvature and relative phalangeal length. Predictive models based on these traits are reported. Published proportions of different locomotor behaviors were regressed against each phalangeal measurement and a size proxy. The relationship between each behavior and skeletal trait was investigated using ordinary least-squares, phylogenetic generalized least-squares (pGLS), and two pGLS transformation methods to determine the model of best-fit. Phalangeal curvature and relative length had significant positive relationships with both suspension and overall arboreal locomotion. Cross-validation analyses demonstrated that relative length and curvature provide accurate predictions of relative suspensory behavior and substrate usage in a range of extant species when used together in predictive models. These regression equations provide a refined method to assess the amount of suspensory and overall arboreal locomotion characterizing species in the catarrhine fossil record. Copyright © 2011 Wiley-Liss, Inc.

Nonvascularized toe phalangeal transfer and distraction lengthening for symbrachydactyly.

PubMed

Patterson, Ryan W; Seitz, William H

2010-04-01

Symbrachydactyly describes a spectrum of congenital hand differences consisting of digital loss resulting in fused short fingers. As the principles for distraction lengthening have evolved, the technique of nonvascularized toe phalangeal transfer to the hand with shortened digits has provided patients with improved outcomes. Nonvascularized toe phalanx to hand transplant with distraction lengthening restores functional length to a skeletally deficient, poorly functioning hand while maintaining an overlying layer of vascular and sensate tissue. The primary goal is improvement of digital length to enhance mechanical advantage and prehension. We describe the technique of nonvascularized toe phalangeal transfer and distraction lengthening for symbrachydactyly, including the following steps: nonvascularized proximal toe phalanx harvest, toe phalanx transfer to hand, pin placement, osteotomy, and closure.

Safe corridors for K-wiring in phalangeal fractures.

PubMed

Rex, C; Vignesh, R; Javed, M; Balaji, Subba Chandra; Premanand, C; Zakki, Syed Ashfaque

2015-01-01

Unstable phalangeal fractures are commonly treated with K-wire fixation. Operative fixation must be used judiciously and with the expectation that the ultimate outcome should be better than the outcome after nonoperative management. It is necessary to achieve a stable fracture fixation and early mobilization. In order to achieve this goal, one should closely understand the safe portals/corridors in hand for K-wire entry for fractures of the phalanges. Safe corridors were defined and tested using a pilot cadaveric and a clinical case study by assessing the outcome. In our prospective case series, 50 patients with 64 phalangeal fractures were treated with closed reduction and K-wires were inserted through safe portals identified by a pilot cadaveric study. On table active finger movement test was done and the results were analyed using radiology, disabilities of the arm, shoulder, and hand (DASH) score and total active motion (TAM). In our study, little finger (n = 28) was the most commonly involved digit. In fracture pattern, transverse (n = 20) and spiral (n = 20) types were common. Proximal phalanx (n = 38) was commonly involved and the common site being the base of the phalanx (n = 28). 47 (95%) patients had excellent TAM and the mean postoperative DASH score was 58.05. All patients achieved excellent and good scores proving the importance of the safe corridor concept. K-wiring through the safe corridor has proved to yield the best clinical results because of least tethering of soft tissues as evidenced by performing "on-table active finger movement test" at the time of surgery. We strongly recommend K-wiring through safe portals in all phalangeal fractures.

Effect of Cortical Screw Diameter on Reduction and Stabilization of Type III Distal Phalanx Fractures: An Equine Cadaveric Study.

PubMed

Kay, Alastair T; Durgam, Sushmitha; Stewart, Matthew; Joslyn, Stephen; Schaeffer, David J; Horn, Gavin; Kesler, Richard; Chew, Peter

2016-11-01

To compare reduction of type III distal phalangeal fractures using 4.5 and 5.5 mm cortical screws placed in lag fashion and an intact hoof capsule model. Cadaveric experimental study. Hooves from 12 adult horses (n=24). Sagittal fractures were created in pairs of distal phalanges after distal interphalangeal joint disarticulation and were reduced with either 4.5 or 5.5 mm cortical screws placed in lag fashion. Contralateral phalanges served as non-reduced controls. Fracture reduction following screw placement was assessed by comparing pre-reduction and post-reduction fracture gap measurements from radiographs using paired t-tests. Effects of incremental loading (0, 135, 270, 540, 800, 1070, and 1335 kg) on fracture gaps in 6 phalanges reduced with 4.5 mm screws and 5 phalanges reduced with 5.5 mm screws were measured from fluoroscopic images and assessed by 2-way ANOVA. Significance was set at P<.05. Type III distal phalanx fractures were reliably created. Only 5.5 mm cortical screws, not 4.5 mm screws, significantly reduced fracture gaps and constrained fracture gap expansion 3 cm distal to the articular surface. Compressive loading closed the fracture gaps at the articular surface in both non-reduced control groups and those reduced with either 5.5 or 4.5 mm screws. The 5.5 mm cortical screws were more effective than 4.5 mm screws in reducing type III distal phalanx fractures and restricting distal fracture gap expansion under load. © Copyright 2016 by The American College of Veterinary Surgeons.

Hair patterns of the lower limb in Central Indian males.

PubMed

Chaurasia, B D

1977-08-01

The distribution of hair of the right lower limb has been studied in a random sample of 220 healthy Central Indian males 17 to 45 years of age. The common hair patterns observed are the proximal phalangeal hair in all toes in 55.45%, the middle phalangeal hair in the third toe in 8.18%, the tibial on the dorsum of foot in 69.55%, and the pedo-cruro-femoral in the lower limb in 70.00% subjects. Comparison of these findings with those of the right upper limb shows that hairiness of the two limbs is correlated, that the dorsum of foot is less hairy than the dorsum of hand, and that the third and second toes are comparable with the fourth and third fingers, respectively, as regards their middle phalangeal hair. Comparison with the available literature shows that the Central Indian males resemble the Whites in having greater frequency of middle phalangeal hair than those of the Negroes, that the dorsum of feet of this population is less hairy than the White and more hairy than the Negroes, and that the general hairiness of the lower limb is more or less equal in the three groups of persons.

Rational treatment for multiple digit congenital absence: case report of nonvascularized toe phalangeal transfers and distraction lengthening for symbrachydactyly.

PubMed

Netscher, David T; Richards, Winston T

2006-02-01

A case is discussed in which a young male was born with symbrachydactyly of multiple digits in whom nonvascularized proximal toe phalanges were transferred to the aphalangic digits when he was an infant. This initial surgical procedure was later followed by webspace deepening and ultimately by distraction lengthening of the digits. At 8 years of age, he has a very functional hand with mobile metacarpophalangeal joints in all reconstructed fingers. In fact, he uses this reconstructed right hand as his dominant extremity. The case is discussed in context of phalangeal growth potential, specific indications for this type of reconstruction, and final long-term outcome. This case also helps to recommend rational treatment protocols for similar congenital hand anomalies.

Congenital sensori-neural deafness associated with onycho-osteo dystrophy and mental retardation (D.O.O.R. syndrome).

PubMed

Cantwell, R J

1975-01-01

A characteristic syndrome is described in which congenital sensori-neural deafness is associated not only with onychodystrophy but also with congenital bony anomalies the most characteristic of which are tri-phalangeal thumbs, bi-phalangeal digits of hands and feet, and dystrophic terminal phalanges of some of the fingers and toes. In addition, there is mental retardation and the dermatoglyphics are characterized by the presence of 10 arches and elevation of the atd angles. The syndrome is inherited as an autosomal recessive. It is suggested that this entity be named the D.O.O.R. Syndrome because of the deafness, onychodystrophy, osteodystrophy and retardation. A similar syndrome without retardation as described by Goodman et al. (1969) appears to be inherited as an autosomal dominant.

[Demographic features and difficulties in rehabilitation in patients referred to hand rehabilitation unit for phalangeal fractures].

PubMed

Sahin, Füsun; Yücel, Serap Dalgiç; Yilmaz, Figen; Ergöz, Ernur; Kuran, Banu

2006-01-01

We evaluated demographic and occupational features of patients with phalangeal fractures of the hand, etiologies and types of injuries, and the results of rehabilitation. The study included 91 fingers of 62 patients (54 males, 8 females; mean age 28+/-13 years; range 4 to 59 years) who were referred to our hand rehabilitation unit for phalangeal fractures. Demographic features, the cause and localization of injury, the type of surgery, time from surgery to rehabilitation, and the follow-up period were determined. At the end of rehabilitation, range of motion (ROM) of the phalangeal joint and total ROM of the injured fingers were assessed using the Strickland-Glogovac rating system. A great majority of injuries were caused by work accidents, followed by sport injuries and falls occurring in students. Sixty patients (96.8%) were right-handed. The fractures occurred in the dominant hand in 29 patients (46.8%). The majority of patients (n=45) were primary school graduates. The most common mechanism of injury was accidents related to heavy work machinery (n=18). The most commonly injured finger and the phalanx were the third finger (n=25, 27.5%) and the proximal phalanx (n=59, 56.7%), respectively. Only 27 patients (43.6%) had a sufficient follow-up with a mean of 79.7+/-46.6 days (range 30 to 254 days). Following rehabilitation, the mean ROM and the total ROM were 45.0+/-22.9 degrees and 63.3+/-16.1 degrees for the injured joint and the thumb, and 31.3+/-22.5 degrees and 122+/-60.3 degrees for the injured joint and the other fingers, respectively. Our data provide important insight into appropriate treatment and rehabilitation of phalangeal fractures, in particular, shortcomings in the treatment and follow-up.

[Symbrachydactyly--a roentgenographic and clinical study of 126 cases].

PubMed

Senrui, H

1984-07-01

One hundred and twenty-six cases of symbrachydactyly were analyzed roentgenographically and clinically. This curious anomaly of the hand is sporadic and of unknown etiology. It is predominantly one-sided, either isolated or combined with ipsilateral pectoral muscle defect (fifty-one cases). On X-ray pictures, the skeletal abnormalities of the hands ranged from mild involvement featured with hypoplastic or aplastic middle phalanges to the most severe involvement in which all the phalanges were missing, providing a continuous spectrum. Even in the mildly affected hands hypoplasia involves all the phalanges and metacarpals, most severely in the middle phanges followed by distal, proximal phalanges and metacarpals in turn. The forearms and arms are less affected than the hands. The tendency is observed in the severely affected hands. In the most severely affected hand all the digits are missing, but there exist several finger-buds which carry often nail rudiments. Synostosis is seen in the remaining hypoplastic metacarpals often and in carpals infrequently. Although remarkable shortening and curving forearm bones are observed often, the humeral involvement remains mild. Abnormalities of muscles and tendons are frequently observed in the hand and forearm. The anomaly is classified roentgenographically into three types: Type I (brachydactyly type) which is featured with fingers having three or two phalanges (fifty-four hands), Type II (partial ectrodactyly type) in which one to four digits have only one phalanx or none(thirty-nine hands), and Type III(total ectrodactyly type) in which all the digits have only one phalanx or none (thirty-five hands). The symbrachydactyly seems to be caused by a extensive defect in an undifferentiated mesenchyme of the arm bud at about developmental stage 16, which may later cause a failure of separation of skeletal and muscular tissues of the hand and forearm or an arrest in their development.

Phalangeal quantitative ultrasound and metabolic control in pre-menopausal women with type 1 diabetes mellitus.

PubMed

Catalano, A; Morabito, N; Di Vieste, G; Pintaudi, B; Cucinotta, D; Lasco, A; Di Benedetto, A

2013-05-01

Several studies have reported increased fracture risk in Type 1 diabetes mellitus (T1DM). Quantitative Ultrasound (QUS) provides information on the structure and elastic properties of bone, which are important determinants of fracture risk, along with bone mineral density. To study phalangeal sites by QUS, examine bone turnover markers and analyze association between these factors with metabolic control in a population of pre-menopausal women with T1DM. Thirty-five T1DM pre-menopausal women (mean age 34.5 ± 6.8 yr) attending the Diabetic Outpatients Clinic in the Department of Internal Medicine, University of Messina, were consecutively enrolled and divided into two groups, taking into account the mean value of glycated hemoglobin in the last three years. Twenty healthy age-matched women served as controls. Phalangeal ultrasound measurements [Amplitude Dependent Speed of Sound (AD-SoS), Ultrasound Bone Profile Index (UBPI), TScore, Z-Score] were performed using a DBM Sonic Bone Profiler. Osteocalcin and deoxypyridinoline served as markers of bone formation and bone resorption, respectively. T1DM women with poor metabolic control showed lower phalangeal QUS values compared to healthy controls (p<0.01) and T1DM women with good metabolic control (p<0.05). No significant differences in QUS measurements were detected between T1DM women with good metabolic control and healthy controls. Lower bone formation and increased bone resorption, although not statistically significant, were observed in patients with poor metabolic control in comparison to patients with good metabolic control. Poor metabolic control may worsen the quality of bone in T1DM. Phalangeal QUS could be considered as a tool to screen T1DM women for osteoporosis in pre-menopausal age.

Two rare cases of adult-onset phalangeal microgeodic syndrome with magnetic resonance imaging-proven bone edema transiently occurring in winter.

PubMed

Nishino, Ayako; Kawashiri, Shin-ya; Nakashima, Yoshikazu; Kawakami, Atsushi

2013-10-01

We report two rare cases of adult-onset phalangeal microgeodic syndrome (PMS), which commonly develops in children. Both cases were Japanese women, with case 1: 60 years old and case 2: 58 years old. They developed swelling and stiffness in their fingers in winter, and their symptoms disappeared without any treatment in summer. Magnetic resonance imaging (MRI) of bilateral hands showed diffuse bone edema of the middle and proximal phalanges in winter, but the abnormal findings also disappeared in summer. The specific abnormalities observed on MRI were very useful for the diagnosis of PMS. Interestingly, they appeared in winter and disappeared in summer in parallel with the symptoms. Copyright © 2013 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

Inhibition of Shh signalling in the chick wing gives insights into digit patterning and evolution.

PubMed

Pickering, Joseph; Towers, Matthew

2016-10-01

In an influential model of pattern formation, a gradient of Sonic hedgehog (Shh) signalling in the chick wing bud specifies cells with three antero-posterior positional values, which give rise to three morphologically different digits by a self-organizing mechanism with Turing-like properties. However, as four of the five digits of the mouse limb are morphologically similar in terms of phalangeal pattern, it has been suggested that self-organization alone could be sufficient. Here, we show that inhibition of Shh signalling at a specific stage of chick wing development results in a pattern of four digits, three of which can have the same number of phalanges. These patterning changes are dependent on a posterior extension of the apical ectodermal ridge, and this also allows the additional digit to arise from the Shh-producing cells of the polarizing region - an ability lost in ancestral theropod dinosaurs. Our analyses reveal that, if the specification of antero-posterior positional values is curtailed, self-organization can then produce several digits with the same number of phalanges. We present a model that may give important insights into how the number of digits and phalanges has diverged during the evolution of avian and mammalian limbs. © 2016. Published by The Company of Biologists Ltd.

Unstable metacarpal and phalangeal fractures: treatment by internal fixation using AO mini-fragment plates and screws.

PubMed

Mumtaz, Mohammad Umar; Farooq, Muneer Ahmad; Rasool, Altaf Ahmad; Kawoosa, Altaf Ahmad; Badoo, Abdul Rashid; Dhar, Shabir Ahmad

2010-07-01

Accurate open reduction and internal fixation for metacarpal and phalangeal fractures of the hand is required in less than 5% of the patients; otherwise, closed treatment techniques offer satisfactory results in most of these cases as these fractures are stable either before or after closed reduction. AO mini-fragment screws and plates, when used in properly selected cases, can provide rigid fixation, allowing early mobilization of joints and hence good functional results while avoiding problems associated with protruding K-wires and immobilization. The advantages of such internal fixation urged us to undertake such a study in our state where such hand injuries are commonly seen. Forty patients with 42 unstable metacarpal and phalangeal fractures were treated with open reduction and internal fixation using AO mini-fragment screws and plates over a period of three years in a prospective manner. The overall results were good in 78.5% of cases, fair in 19% of cases and poor in 2.5% of cases, as judged according to the criteria of the American Society for Surgery of the Hand. This technique is a reasonable option for treating unstable metacarpal and phalangeal fractures as it provides a highly rigid fixation, which is sufficient to allow early mobilization of the adjacent joints, thus helping to achieve good functional results.

Surgical and medical management for fractures of the second through fifth metacarpals in a red ruffed lemur (Varecia rubra).

PubMed

Cerveny, Shannon N S; Harper, Justin; Voges, Andra; Coke, Rob L

2013-03-01

A 21-yr-old female red ruffed lemur (Varecia rubra) was presented with swelling and disuse of the right manus. Severely displaced fractures of metacarpals II-V were diagnosed radiographically. The fractures were surgically stabilized with intramedullary Kirschner wires attached externally with an acrylic external fixator and a bone plate on the dorsal aspect of metacarpal III. The fractures of metacarpals II-V were predominantly healed on radiographs obtained 12 wk after surgery. However, diffuse disuse osteopenia and phalangeal contracture were present, with possible osteomyelitis. An exercise regimen of the affected hand was initiated due to the incomplete extension of the phalanges. After 4 wk of therapy, the extension of the phalanges had improved and the fractures appeared radiographically to be nearly completely healed. Although metacarpal fractures are common in nonhuman primates, they are reported infrequently in the literature.

Phalange Tactile Load Cell

NASA Technical Reports Server (NTRS)

Ihrke, Chris A. (Inventor); Diftler, Myron A. (Inventor); Linn, Douglas Martin (Inventor); Platt, Robert (Inventor); Griffith, Bryan Kristian (Inventor)

2010-01-01

A tactile load cell that has particular application for measuring the load on a phalange in a dexterous robot system. The load cell includes a flexible strain element having first and second end portions that can be used to mount the load cell to the phalange and a center portion that can be used to mount a suitable contact surface to the load cell. The strain element also includes a first S-shaped member including at least three sections connected to the first end portion and the center portion and a second S-shaped member including at least three sections coupled to the second end portion and the center portion. The load cell also includes eight strain gauge pairs where each strain gauge pair is mounted to opposing surfaces of one of the sections of the S-shaped members where the strain gauge pairs provide strain measurements in six-degrees of freedom.

Development of a neural network for early detection of renal osteodystrophy

NASA Astrophysics Data System (ADS)

Cheng, Shirley N.; Chan, Heang-Ping; Adler, Ronald; Niklason, Loren T.; Chang, Chair-Li

1991-07-01

Bone erosion presenting as subperiosteal resorption on the phalanges of the hand is an early manifestation of hyperparathyroidism associated with chronic renal failure. At present, the diagnosis is made by trained radiologists through visual inspection of hand radiographs. In this study, a neural network is being developed to assess the feasibility of computer-aided detection of these changes. A two-pass approach is adopted. The digitized image is first compressed by a Laplacian pyramid compact code. The first neural network locates the region of interest using vertical projections along the phalanges and then the horizontal projections across the phalanges. A second neural network is used to classify texture variations of trabecular patterns in the region using a concurrence matrix as the input to a two-dimensional sensor layer to detect the degree of associated osteopenia. Preliminary results demonstrate the feasibility of this approach.

Clinical and radiological assessment of a family with mild brachydactyly type A1: the usefulness of metacarpophalangeal profiles.

PubMed

Armour, C M; Bulman, D E; Hunter, A G

2000-04-01

The brachydactylies are a group of conditions in which various subtypes have been defined based upon the specific pattern of digital bones involved. Type A1 brachydactyly is principally characterised by maximal involvement of the middle phalanges. We report an extended family with a mild brachydactyly A1 which was, except for some short stature, not associated with any of the additional clinical findings reported in several published families. While all the hand bones tended to be small, the principal features of the affected members were shortened middle and distal phalanges, proximal 1st phalanges, and 5th metacarpals. The feet were similarly involved and tended to have a broad, slightly adducted forefoot. The two affected children showed multiple coned epiphyses. This paper provides a detailed description of the family including the radiographic signs and metacarpophalangeal profiles, which proved to be useful in distinguishing the mildly affected persons.

Prosthetic finger phalanges with lifelike skin compliance for low-force social touching interactions

PubMed Central

2011-01-01

Background Prosthetic arms and hands that can be controlled by the user's electromyography (EMG) signals are emerging. Eventually, these advanced prosthetic devices will be expected to touch and be touched by other people. As realistic as they may look, the currently available prosthetic hands have physical properties that are still far from the characteristics of human skins because they are much stiffer. In this paper, different configurations of synthetic finger phalanges have been investigated for their skin compliance behaviour and have been compared with the phalanges of the human fingers and a phalanx from a commercially available prosthetic hand. Methods Handshake tests were performed to identify which areas on the human hand experience high contact forces. After these areas were determined, experiments were done on selected areas using an indenting probe to obtain the force-displacement curves. Finite element simulations were used to compare the force-displacement results of the synthetic finger phalanx designs with that of the experimental results from the human and prosthetic finger phalanges. The simulation models were used to investigate the effects of (a) varying the internal topology of the finger phalanx and (b) varying different materials for the internal and external layers. Results and Conclusions During handshake, the high magnitudes of contact forces were observed at the areas where the full grasping enclosure of the other person's hand can be achieved. From these areas, the middle phalanges of the (a) little, (b) ring, and (c) middle fingers were selected. The indentation experiments on these areas showed that a 2 N force corresponds to skin tissue displacements of more than 2 mm. The results from the simulation model show that introducing an open pocket with 2 mm height on the internal structure of synthetic finger phalanges increased the skin compliance of the silicone material to 235% and the polyurethane material to 436%, as compared to a configuration with a solid internal geometry. In addition, the study shows that an indentation of 2 N force on the synthetic skin with an open pocket can also achieve a displacement of more than 2 mm, while the finger phalanx from a commercially available prosthetic hand can only achieve 0.2 mm. PMID:21447188

[Relationship of certain skeletal maturity indicators of hand and wrist with adolescent growth spurt].

PubMed

Zhang, Shao-yan; Liu, Gang; Liu, Li-juan; Ma, Zhen-guo; Han, Yi-san; Shen, Xun-zhang; Xu, Rui-long

2008-08-12

To investigate the relationship of certain skeletal maturity indicators of hand and wrist with adolescent growth spurt. 14 757 normal urban children, 7373 boys and 7384 girls, aged 7 - 20, all of Han nationality, from Shanghai, Guangzhou, Wenzhou, Dalian, and Shijiazhuang underwent measurement of height and weight, and left wrist anterior-posterior radiography. The incremental curve was fitted graphically according to the differences between the means for height at series ages. The ages of attainment of eleven skeletal indicators were defined by regression analysis for middle phalange 3, radius, and adductor sesamoid of the first finger. The accelerative phase of adolescent growth spurt was accompanied by becoming square of middle phalange 3 and the appearance of adductor sesamoid of the first finger. Peak growth velocity (PGV) was reached at about the time of epiphysis capping in middle phalange 3 and ossification of the adductor sesamoid of first finger. Decelerated phase of growth was indicated by the beginning of epiphysis fusion in radius and full maturity in adductor sesamoid of first finger. When the epiphysis of middle phalange 3 and the half of epiphysis of radius were respectively fused with their diaphyses, the growth spurt was ended. Certain skeletal maturity indicators of hand and wrist can be used to indicate the period of adolescent growth that a child has reached.

Point-of-Care Phalangeal Bone Mineral Density Measurement Can Reduce the Need of Dual-Energy X-Ray Absorptiometry Scanning in Danish Women at Risk of Fracture.

PubMed

Holmberg, Teresa; Bech, Mickael; Gram, Jeppe; Hermann, Anne Pernille; Rubin, Katrine Hass; Brixen, Kim

2016-03-01

Identifying persons with a high risk of osteoporotic fractures remains a challenge. DXA uptake in women with elevated risk of osteoporosis seems to be depending on distance to scanning facilities. This study aimed to investigate the ability of a small portable scanner in identifying women with reduced bone mineral density (BMD), and to define triage thresholds for pre-selection. Total hip and lumbar spine BMD was measured by dual-energy X-ray absorptiometry and phalangeal BMD by radiographic absorptiometry in 121 Danish women with intermediate or high 10-year fracture probability (aged 61-81 years). Correlation between the two methods was estimated using correlation coefficient (r) and Bland-Altman plots. A moderate correlation between phalangeal BMD versus total hip (r = 0.47) and lumbar spine (r = 0.51), and an AUC on 0.80 was found. The mean difference between phalangeal T score and total hip T score/lumbar spine T score was low, and ranged from -0.26 SD to -0.31 SD depending on site and reference database used for calculation of T scores, but, large variation was seen at an individual level. When applying a triage approach approx. one-third of all DXA scan could be avoided and only 6 % of women in the low-risk group would be false negatives.

Predictors of the postoperative range of finger motion for comminuted periarticular metacarpal and phalangeal fractures treated with a titanium plate.

PubMed

Shimizu, Takamasa; Omokawa, Shohei; Akahane, Manabu; Murata, Keiichi; Nakano, Kenichi; Kawamura, Kenji; Tanaka, Yasuhito

2012-06-01

Plate and screw fixation was introduced for complex fractures of the hand. Several risk factors for a poor functional outcome have been identified, but there is a paucity of evidence regarding predictors of finger stiffness in difficult hand fractures. The purpose of this prospective cohort study was to identify independent prognostic factors of the postoperative total active motion (%TAM) in the treatment of metacarpal and phalangeal fractures. Seventy-two patients (62 males, 10 females; 37±15 years) with periarticular fractures involving metaphyseal comminution and displacement were evaluated at a minimum of 1 year following surgery. There were 49 phalangeal bone fractures, 30 intra-articular fractures and 20 associated soft-tissue injuries. The locations of plate placement were lateral in 42 patients and dorsal in 30. The mean duration from injury to surgery was 7.6 days (range, 0-40 days). There were eight examined variables related to patient characteristics (age, gender and hand dominance), fracture characteristics (fracture location, joint involvement and associated soft-tissue injury) and surgical variables (location of plate placement and duration from injury to surgery). Univariate and multivariate linear regression analysis were used to identify the degree to which variables affect %TAM at the final follow-up. Univariate analysis indicated moderate correlations of %TAM with fracture location, associated soft-tissue injury and age. Multiple linear regression modelling including fracture location, age and associated soft-tissue injury resulted in formulae that could account for 46.3% of the variability in %TAM: fracture location (β=-0.388, p<0.001), age (β=-0.339, p<0.001) and associated soft-tissue injury (β=-0.296, p=0.002). Phalangeal fracture, increasing age and associated soft-tissue injury were important risk factors to identify the postoperative %TAM in the treatment of comminuted periarticular metacarpal or phalangeal fracture with a titanium plate. Copyright © 2012 Elsevier Ltd. All rights reserved.

Aggressive intraosseous lipoma of the intermediate phalanges of the thumb.

PubMed

Hashimoto, Kazuhiko; Nishimura, Shunji; Kakinoki, Ryosuke; Akagi, Masao

2018-07-01

Intraosseous lipomas occurring in the bones of the upper limbs are very rare. The tumor often occurs in long bones, especially the calcaneus. Usually patients with intraosseous lipomas present with mild clinical features. Thus far, bone destruction caused by the tumor has not been reported. The present study reported a case of an aggressive intraosseous lipoma that developed in the intermediate phalanges of the thumb. This is an extremely rare case with extraosseous development, which occurred at a rare site. A 47-year old woman presented to us with right thumb pain and swelling. Computed tomography and magnetic resonance imaging revealed a mass extending to the outer edge of the phalangeal bone. The patient was treated with surgery the remove the tumor. Artificial bone was used to refill the area due to the lack of cancellous bone. During the clinical management of lipomas, it is important to consider that intraosseous lipomas may spread out of the bone; moreover, the tumor should be removed immediately to help reduce the possibility of bone destruction.

Unusual localizations of unicameral bone cysts and aneurysmal bone cysts: A retrospective review of 451 cases.

PubMed

Aycan, Osman Emre; Çamurcu, İsmet Yalkın; Özer, Devrim; Arıkan, Yavuz; Kabukçuoğlu, Yavuz Selim

2015-06-01

Unicameral bone cysts (UBC) and aneurysmal bone cysts (ABC) are benign cystic lesions of bone which are easily diagnosed. However, unusual locations may lead to a false diagnosis. Therefore the aim of this retrospective study was to determine the frequency of unusual localizations. The authors studied 451 cases with histopathologically confirmed diagnosis of UBC or ABC, seen between 1981 and 2012. In the UBC group (352 cases) humerus, femur and calcaneus were found to be the most common sites, while acetabulum, scapula, scaphoid, lunatum, metacarpals, metatarsals, toe phalanges and ulna each accounted for less than 1%. In the ABC group (99 cases) the most common sites of involvement were femur, humerus and tibia, while finger phalanges, ilium, acetabulum, pubis, calcaneus, cuboid, and toe phalanges each accounted for only 1%. The differential diagnosis of cystic bone lesions should include both UBC and ABC. Pain complaints plead for the latter, except in case of fracture.

An interdigit signalling centre instructs coordinate phalanx-joint formation governed by 5′Hoxd–Gli3 antagonism

PubMed Central

Huang, Bau-Lin; Trofka, Anna; Furusawa, Aki; Norrie, Jacqueline L.; Rabinowitz, Adam H.; Vokes, Steven A.; Mark Taketo, M.; Zakany, Jozsef; Mackem, Susan

2016-01-01

The number of phalanges and joints are key features of digit ‘identity' and are central to limb functionality and evolutionary adaptation. Prior chick work indicated that digit phalanges and their associated joints arise in a different manner than the more sparsely jointed long bones, and their identity is regulated by differential signalling from adjacent interdigits. Currently, there is no genetic evidence for this model, and the molecular mechanisms governing digit joint specification remain poorly understood. Using genetic approaches in mouse, here we show that functional 5′Hoxd–Gli3 antagonism acts indirectly, through Bmp signalling from the interdigital mesenchyme, to regulate specification of joint progenitors, which arise in conjunction with phalangeal precursors at the digit tip. Phalanx number, although co-regulated, can be uncoupled from joint specification. We propose that 5′Hoxd genes and Gli3 are part of an interdigital signalling centre that sets net Bmp signalling levels from different interdigits to coordinately regulate phalanx and joint formation. PMID:27713395

Two novel disease-causing variants in BMPR1B are associated with brachydactyly type A1.

PubMed

Racacho, Lemuel; Byrnes, Ashley M; MacDonald, Heather; Dranse, Helen J; Nikkel, Sarah M; Allanson, Judith; Rosser, Elisabeth; Underhill, T Michael; Bulman, Dennis E

2015-12-01

Brachydactyly type A1 is an autosomal dominant disorder primarily characterized by hypoplasia/aplasia of the middle phalanges of digits 2-5. Human and mouse genetic perturbations in the BMP-SMAD signaling pathway have been associated with many brachymesophalangies, including BDA1, as causative mutations in IHH and GDF5 have been previously identified. GDF5 interacts directly as the preferred ligand for the BMP type-1 receptor BMPR1B and is important for both chondrogenesis and digit formation. We report pathogenic variants in BMPR1B that are associated with complex BDA1. A c.975A>C (p.(Lys325Asn)) was identified in the first patient displaying absent middle phalanges and shortened distal phalanges of the toes in addition to the significant shortening of middle phalanges in digits 2, 3 and 5 of the hands. The second patient displayed a combination of brachydactyly and arachnodactyly. The sequencing of BMPR1B in this individual revealed a novel c.447-1G>A at a canonical acceptor splice site of exon 8, which is predicted to create a novel acceptor site, thus leading to a translational reading frameshift. Both mutations are most likely to act in a dominant-negative manner, similar to the effects observed in BMPR1B mutations that cause BDA2. These findings demonstrate that BMPR1B is another gene involved with the pathogenesis of BDA1 and illustrates the continuum of phenotypes between BDA1 and BDA2.

Incidence of Treatment for Infection of Buried Versus Exposed Kirschner Wires in Phalangeal, Metacarpal, and Distal Radial Fractures.

PubMed

Ridley, Taylor J; Freking, Will; Erickson, Lauren O; Ward, Christina Marie

2017-07-01

To determine whether there is a difference in the incidence of infection between exposed and buried K-wires when used to treat phalangeal, metacarpal, and distal radius fractures. We conducted a retrospective review identifying all patients aged greater than 16 years who underwent fixation of phalangeal, metacarpal, or distal radius fractures with K-wires between 2007 and 2015. We recorded patient demographic data, fracture location, number of K-wires used, whether K-wires were buried or left exposed, and duration of K-wire placement. A total of 695 patients met inclusion criteria. Surgeons buried K-wires in 207 patients and left K-wires exposed in 488. Infections occurred more frequently in exposed K-wire cases than in buried K-wire ones. Subgroup analysis based on fracture location revealed a significantly increased risk of being treated for infection when exposed K-wires were used for metacarpal fractures. Patients with exposed K-wires for fixation of phalangeal, metacarpal, or distal radius fractures were more likely to be treated for a pin-site infection than those with K-wires buried beneath the skin. Metacarpal fractures treated with exposed K-wires were 2 times more likely to be treated for a pin-site infection (17.6% of exposed K wire cases vs 8.7% of buried K wire cases). Therapeutic IV. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Individual left-hand and right-hand intra-digit representations in human primary somatosensory cortex.

PubMed

Schweisfurth, Meike A; Frahm, Jens; Schweizer, Renate

2015-09-01

Individual intra-digit somatotopy of all phalanges of the middle and little finger of the right and left hand was studied by functional magnetic resonance imaging in 12 healthy subjects. Phalanges were tactilely stimulated and activation in BA 3b of the human primary somatosensory cortex could be observed for each individual phalanx. Activation peaks were further analysed using the Direction/Order (DiOr) method, which identifies somatotopy, if a significantly high number of subjects exhibit ordered distal-to-proximal phalanx representions along a similar direction. Based on DiOr, ordered and similar-direction-aligned intra-digit maps across subjects were found at the left hand for the little and middle finger and at the right hand for the little finger. In these digits the proximal phalanges were represented more medially along the course of the central sulcus than the distal phalanges. This is contrasted by the intra-digit maps for the middle finger of the right hand, which showed larger inter-subject variations of phalanx alignments without a similar within-digit representation across subjects. As all subjects were right-handed and as the middle finger of the dominant hand probably plays a more individual role in everyday tactile performance than the little finger of the right hand and all left-hand digits, the observed variation might reflect a functional somatotopy based on individual use of that particular digit at the dominant hand. © 2015 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

Assessment of Lactose-Free Diet on the Phalangeal Bone Mineral Status in Italian Adolescents Affected by Adult-Type Hypolactasia

PubMed Central

Tagliati, Sylvie; Saccomandi, Daniela; Brusaferro, Andrea; Busoli, Laura; Scala, Andrea; Malaventura, Cristina; Borgna-Pignatti, Caterina

2018-01-01

Adult-type hypolactasia (ATH) is a clinical syndrome of primary lactase deficiency. A lactose-free diet is advisable to avoid the symptoms linked to the condition, but this potentially creates problems for optimal bone mineralization due to reduced calcium intake. To evaluate the effect of the lactose-free diet on the bone mineral status (BMS), we compared the phalangeal BMS of adolescents with ATH to that of peers on a normal diet. Also, we analyzed the correlations between BMS and dietary behavior, physical exercise, and calcium and vitamin D intake. A total of 102 cases and 102 healthy controls filled out a diet record and underwent phalangeal Quantitative Ultrasound (QUS). No difference in BMS was observed. The time spent on lactose-free diet (4.8 ± 3.1 years) was inversely correlated to the BMS. More than 98% of cases consumed lactose-free milk, but calcium and vitamin D intake were significantly lower. Calcium intake was correlated to physical exercise but not to BMS. Our results suggest that a lactose-free diet does not affect the phalangeal BMS of adolescents with primary lactase deficiency when their diet includes lactose-free cow’s milk. However, there is still a significantly lower calcium intake than in the population reference. The inverse correlation observed between the BMS and the time spent on a lactose-free diet suggests that a long-term follow-up is advisable. PMID:29723971

Distraction lengthening of the proximal phalanx in distal thumb amputations.

PubMed

Cansü, Eren; Ünal, Mehmet Bekir; Parmaksızoğlu, Fatih; Gürcan, Serkan

2015-01-01

Thumb amputation is a major cause of hand dysfunction, and the treatment for distal thumb amputations remains controversial. Although finger reconstruction methods using distraction lengthening are known to restore finger length and function, we found no reports in the literature regarding phalangeal lengthening in thumb amputations. We aimed to evaluate proximal phalangeal lengthening in thumb amputations at or near the interphalangeal (IP) joint. We retrospectively evaluated patients who had undergone distraction lengthening of the proximal phalanx of the thumb. All patients underwent osteotomy, either during the initial procedure or as a second-stage procedure. Distraction began 10 days after osteotomy with the use of an external fixator that remained in place until ossification of the gap occurred without bone grafting. Patients were evaluated using the QuickDASH score. Fourteen patients with a mean age of 27 years and a mean follow-up period of 7 years were enrolled. The mean phalangeal lengthening achieved was 20 mm. Ossification occurred at all distraction sites, and the fixators were maintained for a mean of 85 days. The mean healing index was 42.5 days/cm. All 14 patients achieved the desired amount of phalangeal lengthening without major complications such as nonunion, premature union, or gross infection. For reconstruction in cases of distal thumb amputations, distraction lengthening of the proximal phalanx can be used to improve absolute length, web space, and grip distance. The technique is safe and effective, improves functionality/cosmesis, and offers a low complication risk.

Daughter and her mildly affected father with Keipert syndrome.

PubMed

Dumic, Miroslav; Kokic, Durda Dovzak; Matic, Toni; Potocki, Kristina

2006-11-15

A 10-year-old girl with characteristic features of Keipert syndrome (broad terminal phalanges, especially of the thumb and hallux, sensorineural deafness, unusual facial features, large head circumference, maxillary hypoplasia, hoarse voice) and her mildly affected father (broad terminal phalanges, especially of the thumb and hallux, large head circumference, maxillary hypoplasia, and hoarse voice) are presented. The girl is the first reported female with this rare syndrome to date, and the fact that she probably inherited the disease from her father suggests an autosomal dominant pattern of inheritance. (c) 2006 Wiley-Liss, Inc.

Technique of nonvascularized toe phalangeal transfer and distraction lengthening in the treatment of multiple digit symbrachydactyly.

PubMed

Netscher, David T; Lewis, Eric V

2008-06-01

A combination of nonvascularized multiple toe phalangeal transfers, web space deepening, and distraction lengthening may provide excellent function in the child born with the oligodactylous type of symbrachydactyly. These techniques may reconstruct multiple digits, maintaining a wide and stable grip span with good prehension to the thumb. We detail the techniques of each of these 3 stages in reconstruction and describe appropriate patient selection. Potential complications are discussed. However, with strict attention to technical details, these complications can be minimized.

Fine-tuning of Notch signaling sets the boundary of the organ of Corti and establishes sensory cell fates

PubMed Central

Basch, Martin L; Brown, Rogers M; Jen, Hsin-I; Semerci, Fatih; Depreux, Frederic; Edlund, Renée K; Zhang, Hongyuan; Norton, Christine R; Gridley, Thomas; Cole, Susan E; Doetzlhofer, Angelika; Maletic-Savatic, Mirjana; Segil, Neil; Groves, Andrew K

2016-01-01

The signals that induce the organ of Corti and define its boundaries in the cochlea are poorly understood. We show that two Notch modifiers, Lfng and Mfng, are transiently expressed precisely at the neural boundary of the organ of Corti. Cre-Lox fate mapping shows this region gives rise to inner hair cells and their associated inner phalangeal cells. Mutation of Lfng and Mfng disrupts this boundary, producing unexpected duplications of inner hair cells and inner phalangeal cells. This phenotype is mimicked by other mouse mutants or pharmacological treatments that lower but not abolish Notch signaling. However, strong disruption of Notch signaling causes a very different result, generating many ectopic hair cells at the expense of inner phalangeal cells. Our results show that Notch signaling is finely calibrated in the cochlea to produce precisely tuned levels of signaling that first set the boundary of the organ of Corti and later regulate hair cell development. DOI: http://dx.doi.org/10.7554/eLife.19921.001 PMID:27966429

The thumb of Miocene apes: new insights from Castell de Barberà (Catalonia, Spain).

PubMed

Almécija, Sergio; Alba, David M; Moyà-Solà, Salvador

2012-07-01

Primate hands display a major selective compromise between locomotion and manipulation. The thumb may or may not participate in locomotion, but it plays a central role in most manipulative activities. Understanding whether or not the last common ancestor of humans and Pan displayed extant-ape-like hand proportions (i.e., relatively long fingers and a short thumb) can be clarified by the analysis of Miocene ape hand remains. Here we describe new pollical remains-a complete proximal phalanx and a partial distal phalanx-from the middle/late Miocene site of Castell de Barberà (ca., 11.2-10.5 Ma, Vallès-Penedès Basin), and provide morphometric and qualitative comparisons with other available Miocene specimens as well as extant catarrhines (including humans). Our results show that all available Miocene taxa (Proconsul, Nacholapithecus, Afropithecus, Sivapithecus, Hispanopithecus, Oreopithecus, and the hominoid from Castell de Barberà) share a similar phalangeal thumb morphology: the phalanges are relatively long, and the proximal phalanges have a high degree of curvature, marked insertions for the flexor muscles, a palmarly bent trochlea and a low basal height. All these features suggest that these Miocene apes used their thumb with an emphasis on flexion, most of them to powerfully assist the fingers during above-branch, grasping arboreal locomotion. Moreover, in terms of relative proximal phalangeal length, the thumb of Miocene taxa is intermediate between the long-thumbed humans and the short-thumbed extant apes. Together with previous evidence, this suggests that a moderate-length hand with relatively long thumb-involved in locomotion-is the original hand morphotype for the Hominidae. Copyright © 2012 Wiley Periodicals, Inc.

Postural and Intention Tremors: A Detailed Clinical Study of Essential Tremor vs. Parkinson’s Disease

PubMed Central

Sternberg, Eliezer J.; Alcalay, Roy N.; Levy, Oren A.; Louis, Elan D.

2013-01-01

Background: An estimated 30–50% of essential tremor (ET) diagnoses are incorrect, and the true diagnosis in those patients is often Parkinson’s disease (PD) or other tremor disorders. There are general statements about the tremor in these ET and PD, but published data on the more subtle characteristics of tremor are surprisingly limited. Postural tremor may occur in both disorders, adding to the difficulty. There are several anecdotal impressions regarding specific features of postural tremor in ET vs. PD, including joint distribution (e.g., phalanges, metacarpal-phalangeal joints, wrist), tremor directionality (e.g., flexion-extension vs. pronation-supination), and presence of intention tremor. However, there is little data to support these impressions. Methods: In this cross-sectional study, 100 patients (ET, 50 PD) underwent detailed videotaped neurological examinations. Arm tremor was rated by a movement disorder neurologist who assessed severity and directionality across multiple joints. Results: During sustained arm extension, ET patients exhibited more wrist than metacarpal-phalangeal and phalangeal joint tremor than did PD patients (p < 0.001), and more wrist flexion-extension tremor than wrist pronation-supination tremor (p < 0.001). During the finger-nose-finger maneuver, intention tremor was present in approximately one in four (28%) ET patients vs. virtually none (4%) of the Parkinson’s patients (p < 0.001). Conclusions: We evaluated the location, severity, and directionality of postural tremor in ET and PD, and the presence of intention tremor, observing several clinical differences. We hope that detailed phenomenological data on tremor in ET and PD will help practicing physicians delineate the two diseases. PMID:23717300

Return to Play After Forearm and Hand Injuries in the National Basketball Association.

PubMed

Morse, Kyle W; Hearns, Krystle A; Carlson, Michelle Gerwin

2017-02-01

Hand injuries can result in significant time away from competition for professional basketball players. Time to return to play after hand injuries in elite athletes has not been well described. To report the return to play from metacarpal fractures, phalangeal fractures, and thumb ligament tears in National Basketball Association (NBA) players over a 5-year period. Descriptive epidemiology study. The NBA transaction report was analyzed from January 2009 to May 2014. Players were identified if they were added to the inactive list (IL), missed games due to their injury, or underwent surgery as a result of hand injury. Number of games missed due to injury, days spent on the IL, and age at injury were calculated by injury type and location. One hundred thirty-seven injuries were identified: 39 injuries to the hand and 98 injuries to the finger. Three major injury patterns were identified and analyzed: metacarpal fractures (n = 26), phalangeal fractures (n = 33), and thumb ligament tears (n = 9). The type of injury sustained affected return to play ( P < .05). All thumb ligament tears required surgery and had the longest return to play of 67.5 ± 17.7 days ( P < .05). The return to play for surgically treated metacarpal fractures (56.7 ± 26.3 days) was significantly greater than nonsurgically treated metacarpal fractures (26.3 ± 12.1 days; P < .01). Return to play for surgically repaired phalangeal fractures (46.2 ± 10.8 days) trended greater but was not significantly different than phalangeal fractures treated nonsurgically (33.3 ± 28.5 days; P = .21). Hand injuries in professional basketball players can lead to prolonged periods of time away from competition, especially after surgery. This study provides guidelines on expected return to play in the NBA after these common hand injuries.

Paws for thought: comparative radiologic anatomy of the mammalian forelimb.

PubMed

Gough-Palmer, Antony L; Maclachlan, Jody; Routh, Andrew

2008-01-01

All mammals share a remarkably similar skeleton based on a common template. This commonality is particularly well illustrated by the versatile pentadactyl limb, upon which all mammalian limbs are based. For most mammals, the primary function of the forelimb is locomotion. The forelimb has been successfully adapted in mammals of all sizes and in terrestrial, arboreal, aquatic, and airborne environments. In primates, the forelimbs have developed such that speed and stamina have been sacrificed for an increased range of movement, which in turn has provided increased manual dexterity. For instance, chimpanzee hands are pronated and the fingers are flexed, and the phalanges are longer and exhibit much more robust insertion areas for flexor tendons. Ungulates (hoofed mammals), on the other hand, have evolved to maximize speed and stamina in quadrupedal locomotion. The two main orders of ungulates have elongated phalanges and metacarpals; all ungulates have lost the first metacarpal. The cat family represents some of the most highly evolved predators. Cats' forelimbs are designed for speed, power, and acceleration rather than for stamina; they maintain all five metacarpals and phalanges, although the first digit is relatively small. (c) RSNA, 2008

[Clinical and radiographic evaluation of a new percutaneous technique for moderate to severe hallux valgus deformity].

PubMed

Vélez-de Lachica, J C; Valdez-Jiménez, L A; Inzunza-Sánchez, J M

2017-01-01

Hallux valgus is considered the most common musculoskeletal deformity, with a prevalence of 88%. There are more than 130 surgical techniques for its treatment; currently, percutaneous ones are popular; however, they do not take into account the metatarsal-phalangeal correction angle. The aim of this study is to propose a modified technique for the correction of the percutaneous metatarsal-phalangeal and inter-metatarsal angles and to evaluate its clinical and radiological results. An experimental, prospective and longitudinal study in 10 patients with moderate to severe hallux valgus according to the classification of Coughlin and Mann were collected; the results were evaluated with the AOFAS scale at 15, 30, 60 and 90 days. The McBride technique and the technique of percutaneous anchor with the proposed amendment were performed. The AOFAS scale was applied as described, finding a progressive increase of the rating; the average correction of the inter-metatarsal angle was 8.8 degrees and of the metatarsal-phalangeal, 9.12. The modified technique of percutaneous anchor showed clear clinical and radiographic improvements in the short term. Our modified technique is proposed for future projects, including a large sample with long-term follow-up.

Trabecular architecture of the manual elements reflects locomotor patterns in primates.

PubMed

Matarazzo, Stacey A

2015-01-01

The morphology of trabecular bone has proven sensitive to loading patterns in the long bones and metacarpal heads of primates. It is expected that we should also see differences in the manual digits of primates that practice different methods of locomotion. Primate proximal and middle phalanges are load-bearing elements that are held in different postures and experience different mechanical strains during suspension, quadrupedalism, and knuckle walking. Micro CT scans of the middle phalanx, proximal phalanx and the metacarpal head of the third ray were used to examine the pattern of trabecular orientation in Pan, Gorilla, Pongo, Hylobates and Macaca. Several zones, i.e., the proximal ends of both phalanges and the metacarpal heads, were capable of distinguishing between knuckle-walking, quadrupedal, and suspensory primates. Orientation and shape seem to be the primary distinguishing factors but differences in bone volume, isotropy index, and degree of anisotropy were seen across included taxa. Suspensory primates show primarily proximodistal alignment in all zones, and quadrupeds more palmar-dorsal orientation in several zones. Knuckle walkers are characterized by having proximodistal alignment in the proximal ends of the phalanges and a palmar-dorsal alignment in the distal ends and metacarpal heads. These structural differences may be used to infer locmotor propensities of extinct primate taxa.

Kaufman oculo-cerebro-facial syndrome in a child with small and absent terminal phalanges and absent nails.

PubMed

Kariminejad, Ariana; Ajeawung, Norbert Fonya; Bozorgmehr, Bita; Dionne-Laporte, Alexandre; Molidperee, Sirinart; Najafi, Kimia; Gibbs, Richard A; Lee, Brendan H; Hennekam, Raoul C; Campeau, Philippe M

2017-04-01

Kaufman oculo-cerebro-facial syndrome (KOS) is caused by recessive UBE3B mutations and presents with microcephaly, ocular abnormalities, distinctive facial morphology, low cholesterol levels and intellectual disability. We describe a child with microcephaly, brachycephaly, hearing loss, ptosis, blepharophimosis, hypertelorism, cleft palate, multiple renal cysts, absent nails, small or absent terminal phalanges, absent speech and intellectual disability. Syndromes that were initially considered include DOORS syndrome, Coffin-Siris syndrome and Dubowitz syndrome. Clinical investigations coupled with karyotype analysis, array-comparative genomic hybridization, exome and Sanger sequencing were performed to characterize the condition in this child. Sanger sequencing was negative for the DOORS syndrome gene TBC1D24 but exome sequencing identified a homozygous deletion in UBE3B (NM_183415:c.3139_3141del, p.1047_1047del) located within the terminal portion of the HECT domain. This finding coupled with the presence of characteristic features such as brachycephaly, ptosis, blepharophimosis, hypertelorism, short palpebral fissures, cleft palate and developmental delay allowed us to make a diagnosis of KOS. In conclusion, our findings highlight the importance of considering KOS as a differential diagnosis for patients under evaluation for DOORS syndrome and expand the phenotype of KOS to include small or absent terminal phalanges, nails, and the presence of hallux varus and multicystic dysplastic kidneys.

[Distraction Osteogenesis is an Effective Method to Lengthen Digits in Congenital Malformations].

PubMed

Mann, M; Hülsemann, W; Winkler, F; Habenicht, R

2016-02-01

The aim of this study was to investigate the feasible amount of lengthening by distraction osteogenesis in congenital hand deficiencies. A total of 60 patients (1.6-17.8 years) underwent lengthening of 71 bones between 1994 and 2014. Bone lengthening was performed on 46 metacarpals and 25 phalanges. Mostly the first (n=30) and the fifth (n=21) rays were lengthened. Bone lengthening was performed to treat primarily symbrachydactyly (b=32) and amniotic band syndrome (n=10). To analyze the amount of lengthening preoperative radiographs and radiographs taken while removing the external fixator were compared. The charts were reviewed regarding age at surgery, duration of lengthening, duration of bony consolidation, complication, etc. The average of metacarpal distraction was 18.4 mm=73% lengthening with respect to the preoperative length; the average of phalange distraction was 14.0 mm=77% of the preoperative length. In both, metacarpals and phalanges, a lengthening of > 100% of the preoperative bone length was possible. In target length was reached in 89% of the procedures. The average time for consolidation was 6.1 (1-20) days/mm lengthening. The external fixator was in use on average for 140 (50-346) days. After removing of the external fixator an axial K-wire was used to stabilize the callus in 9 procedure, and an iliac bone craft plus axial K-wire in 11 procedures. The rate of complications was 30% (early consolidation, deviation, joint dislocation, pin infection, tendon dislocation). All complications could be treated without with acceptable results. Metacarpal and phalangeal distraction lengthening is an effective but demanding technique for ray reconstruction in congenital malformations of the hand. It is possible to lengthen a bone by more than 100%. Complications are common, but in most cases easy to handle. © Georg Thieme Verlag KG Stuttgart · New York.

Return to Play After Forearm and Hand Injuries in the National Basketball Association

PubMed Central

Morse, Kyle W.; Hearns, Krystle A.; Carlson, Michelle Gerwin

2017-01-01

Background: Hand injuries can result in significant time away from competition for professional basketball players. Time to return to play after hand injuries in elite athletes has not been well described. Purpose: To report the return to play from metacarpal fractures, phalangeal fractures, and thumb ligament tears in National Basketball Association (NBA) players over a 5-year period. Study Design: Descriptive epidemiology study. Methods: The NBA transaction report was analyzed from January 2009 to May 2014. Players were identified if they were added to the inactive list (IL), missed games due to their injury, or underwent surgery as a result of hand injury. Number of games missed due to injury, days spent on the IL, and age at injury were calculated by injury type and location. Results: One hundred thirty-seven injuries were identified: 39 injuries to the hand and 98 injuries to the finger. Three major injury patterns were identified and analyzed: metacarpal fractures (n = 26), phalangeal fractures (n = 33), and thumb ligament tears (n = 9). The type of injury sustained affected return to play (P < .05). All thumb ligament tears required surgery and had the longest return to play of 67.5 ± 17.7 days (P < .05). The return to play for surgically treated metacarpal fractures (56.7 ± 26.3 days) was significantly greater than nonsurgically treated metacarpal fractures (26.3 ± 12.1 days; P < .01). Return to play for surgically repaired phalangeal fractures (46.2 ± 10.8 days) trended greater but was not significantly different than phalangeal fractures treated nonsurgically (33.3 ± 28.5 days; P = .21). Conclusion: Hand injuries in professional basketball players can lead to prolonged periods of time away from competition, especially after surgery. This study provides guidelines on expected return to play in the NBA after these common hand injuries. PMID:28251168

Hallux valgus correction using transarticular lateral release with distal chevron osteotomy.

PubMed

Choi, Young Rak; Lee, Ho Seong; Jeong, Jae Jung; Kim, Sang Woo; Jeon, In-Ho; Lee, Dong Ho; Lee, Woo Chun

2012-10-01

Transarticular lateral release through a medial incision can avoid a dorsal incision. This study investigated outcomes following hallux valgus correction using transarticular lateral release, distal chevron metatarsal osteotomy and Akin phalangeal osteotomy through one medial incision. Between June 2004 and May 2009, a single surgeon performed a transarticular lateral release, distal chevron metatarsal osteotomy and Akin phalangeal osteotomy through one medial incision for hallux valgus on a total of 103 feet of 68 patients. The average patient age at the time of surgery was 51 years, and the average followup was 27 months. The average preoperative and final followup results were: 1) hallux valgus angle improvement from 29 degrees to 5 degrees, 2) intermetatarsal angle from 13 degrees to 5 degrees and 3) medial sesamoid bone position from 3 to 1 (p < 0.05 for each variable). The average AOFAS scores were improved from 49 to 92, and the VAS pain scores were improved from 7 to 1 (p < 0.05 for both variables). No patient had a serious complication such as infection, avascular necrosis, nonunion, transfer-metatarsalgia, or first metatarsophalangeal joint arthritis. Hallux valgus correction using transarticular lateral release, distal chevron metatarsal osteotomy and Akin phalangeal osteotomy through one medial incision was found to be effective and safe. The advantages include that the procedure is simple, early ambulation is possible, and there is no dorsal scarring.

Automated bone age assessment of older children using the radius

NASA Astrophysics Data System (ADS)

Tsao, Sinchai; Gertych, Arkadiusz; Zhang, Aifeng; Liu, Brent J.; Huang, Han K.

2008-03-01

The Digital Hand Atlas in Assessment of Skeletal Development is a large-scale Computer Aided Diagnosis (CAD) project for automating the process of grading Skeletal Development of children from 0-18 years of age. It includes a complete collection of 1,400 normal hand X-rays of children between the ages of 0-18 years of age. Bone Age Assessment is used as an index of skeletal development for detection of growth pathologies that can be related to endocrine, malnutrition and other disease types. Previous work at the Image Processing and Informatics Lab (IPILab) allowed the bone age CAD algorithm to accurately assess bone age of children from 1 to 16 (male) or 14 (female) years of age using the Phalanges as well as the Carpal Bones. At the older ages (16(male) or 14(female) -19 years of age) the Phalanges as well as the Carpal Bones are fully developed and do not provide well-defined features for accurate bone age assessment. Therefore integration of the Radius Bone as a region of interest (ROI) is greatly needed and will significantly improve the ability to accurately assess the bone age of older children. Preliminary studies show that an integrated Bone Age CAD that utilizes the Phalanges, Carpal Bones and Radius forms a robust method for automatic bone age assessment throughout the entire age range (1-19 years of age).

[The biphalangy of the thumb. General review of the literature].

PubMed

Guillem, P; Demondion, X; Drizenko, A; Fontaine, C

1999-09-01

The thumb has only two phalanges whereas the other fingers present three. For two millennia, many anatomists tried to solve this riddle. Four different theories can be found in the review of literature, to explain what element misses in the radial column. In the first theory (Galen), the first metacarpal should be the proximal phalanx of the thumb. The particular ossification of the first metacarpal advocates for this theory. In the second theory (Sappey), the first metacarpal should result from the fusion between the true first metacarpal and the proximal phalanx of the thumb, and the proximal epiphysis should be constituted from both metacarpal and phalangeal parts. In the third theory (Paturet), the middle phalanx is thought to be missing. Apart morphological considerations, the main argument refers to symbrachydactyly, which consists in decreasing digital ray length (by reducing the middle phalanx), and usually affects digits excluding the thumb. In case the thumb is affected (in complex symbrachydactylies), the reduction concerns thus the first metacarpal, suggesting that the thumb middle phalanx has already disappeared. In the fourth theory (Pfitzner), the distal phalanx of the thumb should result from the fusion between the second and third phalanges of the thumb. This mechanism, named symphalangy, is well known in the foot, especially in the fifth toe, but also for the other toes, and even in the two ulnar fingers.

Digital Lengthening to Treat Finger Deficiency: An Experience of 201 Digits in 104 Patients

PubMed Central

2017-01-01

Objectives. We evaluated the results of digital lengthening by distraction and second-stage bone graft. Methods. We treated finger deficiency of 201 digits in 104 patients (68 males, 36 females) by digital distraction and second-stage bone graft. The distraction was performed with a rate of 1 mm/day (for the first ten days) and 0.5 mm/day followed by using a self-designed bilateral tubal-helical external fixator. The mean follow-up period was 42 months (range 6 to 60 months). Results. The mean lengthening was 29.2 mm (range 25 to 40 mm) and 18.7 mm (range 12 to 32 mm) for metacarpal bones and phalanges, respectively. The mean elongation rate was 174.4% (range 145% to 202%) and 184.8% (range 115% to 283%) for metacarpal bones and phalanges, respectively. The static two-point discriminations and SpO2 showed no significant differences before and after distraction. Four complications were observed (two skin ruptures and two phalangeal splitting). No pin tract infection or tendon rupture showed. Digital lengthening improved functions of the hand. Conclusion. Digital distraction and second-stage bone graft is an effective method to compensate disabilities caused by lack of finger length. It could be an alternative plan for patients with thumb deficiency instead of toe-to-thumb transplant and patients with finger deficiency instead of ray resection. PMID:28286765

Digital Lengthening to Treat Finger Deficiency: An Experience of 201 Digits in 104 Patients.

PubMed

Ding, Zhenyu; Zhu, Xiaozhong; Fu, Kai; Zheng, Xianyou

2017-01-01

Objectives. We evaluated the results of digital lengthening by distraction and second-stage bone graft. Methods. We treated finger deficiency of 201 digits in 104 patients (68 males, 36 females) by digital distraction and second-stage bone graft. The distraction was performed with a rate of 1 mm/day (for the first ten days) and 0.5 mm/day followed by using a self-designed bilateral tubal-helical external fixator. The mean follow-up period was 42 months (range 6 to 60 months). Results. The mean lengthening was 29.2 mm (range 25 to 40 mm) and 18.7 mm (range 12 to 32 mm) for metacarpal bones and phalanges, respectively. The mean elongation rate was 174.4% (range 145% to 202%) and 184.8% (range 115% to 283%) for metacarpal bones and phalanges, respectively. The static two-point discriminations and SpO 2 showed no significant differences before and after distraction. Four complications were observed (two skin ruptures and two phalangeal splitting). No pin tract infection or tendon rupture showed. Digital lengthening improved functions of the hand. Conclusion. Digital distraction and second-stage bone graft is an effective method to compensate disabilities caused by lack of finger length. It could be an alternative plan for patients with thumb deficiency instead of toe-to-thumb transplant and patients with finger deficiency instead of ray resection.

Brazilian Pediatric Reference Data for Quantitative Ultrasound of Phalanges According to Gender, Age, Height and Weight

PubMed Central

de Carvalho, Wellington Roberto Gomes; de Moraes, Anderson Marques; Roman, Everton Paulo; Santos, Keila Donassolo; Medaets, Pedro Augusto Rodrigues; Veiga-Junior, Nélio Neves; Coelho, Adrielle Caroline Lace de Moraes; Krahenbühl, Tathyane; Sewaybricker, Leticia Esposito; Barros-Filho, Antonio de Azevedo; Morcillo, Andre Moreno; Guerra-Júnior, Gil

2015-01-01

Aims To establish normative data for phalangeal quantitative ultrasound (QUS) measures in Brazilian students. Methods The sample was composed of 6870 students (3688 females and 3182 males), aged 6 to 17 years. The bone status parameter, Amplitude Dependent Speed of Sound (AD-SoS) was assessed by QUS of the phalanges using DBM Sonic BP (IGEA, Carpi, Italy) equipment. Skin color was obtained by self-evaluation. The LMS method was used to derive smoothed percentiles reference charts for AD-SoS according to sex, age, height and weight and to generate the L, M, and S parameters. Results Girls showed higher AD-SoS values than boys in the age groups 7–16 (p<0.001). There were no differences on AD-SoS Z-scores according to skin color. In both sexes, the obese group showed lower values of AD-SoS Z-scores compared with subjects classified as thin or normal weight. Age (r2 = 0.48) and height (r2 = 0.35) were independent predictors of AD-SoS in females and males, respectively. Conclusion AD-SoS values in Brazilian children and adolescents were influenced by sex, age and weight status, but not by skin color. Our normative data could be used for monitoring AD-SoS in children or adolescents aged 6–17 years. PMID:26043082

A Non-Contact Measurement System for the Range of Motion of the Hand

PubMed Central

Pham, Trieu; Pathirana, Pubudu N.; Trinh, Hieu; Fay, Pearse

2015-01-01

An accurate and standardised tool to measure the active range of motion (ROM) of the hand is essential to any progressive assessment scenario in hand therapy practice. Goniometers are widely used in clinical settings for measuring the ROM of the hand. However, such measurements have limitations with regard to inter-rater and intra-rater reliability and involve direct physical contact with the hand, possibly increasing the risk of transmitting infections. The system proposed in this paper is the first non-contact measurement system utilising Intel Perceptual Technology and a Senz3D Camera for measuring phalangeal joint angles. To enhance the accuracy of the system, we developed a new approach to achieve the total active movement without measuring three joint angles individually. An equation between the actual spacial position and measurement value of the proximal inter-phalangeal joint was established through the measurement values of the total active movement, so that its actual position can be inferred. Verified by computer simulations, experimental results demonstrated a significant improvement in the calculation of the total active movement and successfully recovered the actual position of the proximal inter-phalangeal joint angles. A trial that was conducted to examine the clinical applicability of the system involving 40 healthy subjects confirmed the practicability and consistency in the proposed system. The time efficiency conveyed a stronger argument for this system to replace the current practice of using goniometers. PMID:26225976

A pictorial review of reconstructive foot and ankle surgery: hallux abductovalgus

PubMed Central

Meyr, Andrew J; Singh, Salil; Chen, Oliver; Ali, Sayed

2015-01-01

This pictorial review focuses on basic procedures performed within the field of podiatric surgery, specifically for the hallux abductovalgus or “bunion” deformity. Our goal is to define objective radiographic parameters that surgeons utilize to initially define deformity, lead to procedure selection and judge post-operative outcomes. We hope that radiologists will employ this information to improve their assessment of post-operative radiographs following reconstructive foot surgeries. First, relevant radiographic measurements are defined and their role in procedure selection explained. Second, the specific surgical procedures of the distal metatarsal, metatarsal shaft, metatarsal base, and phalangeal osteotomies are described in detail. Additional explanations of arthrodesis of the first metatarsal-phalangeal and metatarsal-cuneiform joints are also provided. Finally, specific plain film radiographic findings that judge post-operative outcomes for each procedure are detailed. PMID:26622935

In-vivo investigation of material quality of bone tissue by measuring apparent phalangeal ultrasound transmission velocity.

PubMed

Kann, P; Schulz, U; Klaus, D; Piepkorn, B; Beyer, J

1995-01-01

The square of ultrasound transmission velocity in a material is related to the modulus of elasticity, which is known to be an indicator of stability in bone. The aim of our study was to use ultrasound transmission velocity to obtain information about the material properties of bone tissue, keeping other factors possibly influencing ultrasound transmission as constant as possible. Apparent phalangeal ultrasound transmission velocity (APU) measured in 54 isolated, fresh pig phalanges was shown to be independent of bone mineral density (BMD) measured by SPA. Fastest sound transmission led exclusively through cortical bone so that intertrabecular connectivity in spongious bone could not influence the result. In humans APU was measured in the mediolateral direction at the midphalanx of the middle finger. In 53 healthy subjects (15-81 years old; 27 women, 26 men), there was a decrease of APU with age (r = -0.30, p < 0.05). Further, when comparing the results of both hands intraindividually almost identical values indicated constant intraindividual architecture of bone at this location. There was no evidence for a relation of APU to physical load comparing dominant and nondominant hand and relating the results to subjectively estimated physical load. In a second group of 43 perimenopausal women (47-60 years old), APU, which again decreased with age (r = -0.33, p < 0.05), was found not to be correlated to BMD measured by SPA at the distal forearm (cortical bone).(ABSTRACT TRUNCATED AT 250 WORDS)

Walking, running and the evolution of short toes in humans.

PubMed

Rolian, Campbell; Lieberman, Daniel E; Hamill, Joseph; Scott, John W; Werbel, William

2009-03-01

The phalangeal portion of the forefoot is extremely short relative to body mass in humans. This derived pedal proportion is thought to have evolved in the context of committed bipedalism, but the benefits of shorter toes for walking and/or running have not been tested previously. Here, we propose a biomechanical model of toe function in bipedal locomotion that suggests that shorter pedal phalanges improve locomotor performance by decreasing digital flexor force production and mechanical work, which might ultimately reduce the metabolic cost of flexor force production during bipedal locomotion. We tested this model using kinematic, force and plantar pressure data collected from a human sample representing normal variation in toe length (N=25). The effect of toe length on peak digital flexor forces, impulses and work outputs was evaluated during barefoot walking and running using partial correlations and multiple regression analysis, controlling for the effects of body mass, whole-foot and phalangeal contact times and toe-out angle. Our results suggest that there is no significant increase in digital flexor output associated with longer toes in walking. In running, however, multiple regression analyses based on the sample suggest that increasing average relative toe length by as little as 20% doubles peak digital flexor impulses and mechanical work, probably also increasing the metabolic cost of generating these forces. The increased mechanical cost associated with long toes in running suggests that modern human forefoot proportions might have been selected for in the context of the evolution of endurance running.

Receptor tyrosine kinase-like orphan receptor 2 (ROR2) and Indian hedgehog regulate digit outgrowth mediated by the phalanx-forming region.

PubMed

Witte, Florian; Chan, Danny; Economides, Aris N; Mundlos, Stefan; Stricker, Sigmar

2010-08-10

Elongation of the digit rays resulting in the formation of a defined number of phalanges is a process poorly understood in mammals, whereas in the chicken distal mesenchymal bone morphogenetic protein (BMP) signaling in the so-called phalanx-forming region (PFR) or digit crescent (DC) seems to be involved. The human brachydactylies (BDs) are inheritable conditions characterized by variable degrees of digit shortening, thus providing an ideal model to analyze the development and elongation of phalanges. We used a mouse model for BDB1 (Ror2(W749X/W749X)) lacking middle phalanges and show that a signaling center corresponding to the chick PFR exists in the mouse, which is diminished in BDB1 mice. This resulted in a strongly impaired elongation of the digit condensations due to reduced chondrogenic commitment of undifferentiated distal mesenchymal cells. We further show that a similar BMP-based mechanism accounts for digit shortening in a mouse model for the closely related condition BDA1 (Ihh(E95K/E95K)), altogether indicating the functional significance of the PFR in mammals. Genetic interaction experiments as well as pathway analysis in BDB1 mice suggest that Indian hedgehog and WNT/beta-catenin signaling, which we show is inhibited by receptor tyrosine kinase-like orphan receptor 2 (ROR2) in distal limb mesenchyme, are acting upstream of BMP signaling in the PFR.

Sudden death in spondylo-meta-epiphyseal dysplasia, short limb-abnormal calcification type.

PubMed

Dias, Cristina; Cairns, Robyn; Patel, Millan S

2009-01-01

The spondylo-meta-epiphyseal dysplasias are an expanding group of skeletal dysplasias with specific features differentiating each subtype. We review the precocious carpal mineralization, unique metacarpal shape, triangular distal phalanges and mushroom cloud-shaped proximal phalanges present at an early age in spondylo-meta-epiphyseal dysplasia, short limb-abnormal calcification type (SMED SL-AC) and report two patients with clinical and radiographic features consistent with SMED SL-AC, who died suddenly because of spinal cord compression. The patients presented are female siblings, providing further evidence for autosomal recessive inheritance. Cervical cord compression is found in half of reported patients and is the major cause of mortality. SMED SL-AC should be added to the list of genetic causes of sudden death. Radiological features in the hand may be used in the first few years of life to support an early diagnosis and thus allow for prevention of premature demise.

Human grasp assist device and method of use

NASA Technical Reports Server (NTRS)

Linn, Douglas Martin (Inventor); Ihrke, Chris A. (Inventor); Diftler, Myron A. (Inventor)

2012-01-01

A grasp assist device includes a glove portion having phalange rings, contact sensors for measuring a grasping force applied by an operator wearing the glove portion, and a tendon drive system (TDS). The device has flexible tendons connected to the phalange rings for moving the rings in response to feedback signals from the sensors. The TDS is connected to each of the tendons, and applies an augmenting tensile force thereto via a microcontroller adapted for determining the augmenting tensile force as a function of the grasping force. A method of augmenting a grasping force of an operator includes measuring the grasping force using the sensors, encoding the grasping force as the feedback signals, and calculating the augmenting tensile force as a function of the feedback signals using the microcontroller. The method includes energizing at least one actuator of a tendon drive system (TDS) to thereby apply the augmenting tensile force.

Ultrasonography in determining pubertal growth and bone age.

PubMed

Torenek Ağırman, Kubra; Bilge, Osman Murat; Miloğlu, Özkan

2018-05-02

The purpose of this study is to evaluate the compatibility of ultrasonographic data with hand-wrist radiographs taken to determine the extent of pubertal growth and bone age in patients and investigate the usability of ionizing radiation-free ultrasonography instead of conventional radiography. In this study, a total of 120 children from 10 to 17 years old (mean age was 168 months ± 27.5 months) were treated with routine radiographs before orthodontic treatment, and ultrasonographic imaging was performed on the wrists the same day. Researchers examined the phalanges, sesamoid bone, and radial bone distal epiphysis-diaphysis comparatively in each patient by both imaging methods and statistical evaluation. There was no statistically significant difference between conventional radiography and ultrasonography values at 13 points except for PP1 (proximal phalanges of the first finger), PP2 (proximal phalanges of the second finger), and radial epiphysis (p > 0.05). PP1, PP2, and radial epiphysis showed a statistically significant difference (p < 0.05). The CBA (bone age obtained from conventional radiographs) of the females was found to be larger than their CA (chronological age) and their UBA (ultrasonographic bone age). For males; the means of the CBA, UBA and CA values close to each other. In females and males; there was a strong correlation between the CA, the UBA and the CBA (p < 0.01). Ultrasonography gives detailed information about epiphyseal diaphysis relations. It can be used as an alternative to conventional radiography in the detection of bone age and pubertal growth, owing to the absence of ionizing radiation.

Geode development and multiple fractures in rheumatoid arthritis.

PubMed

Lowthian, P J; Calin, A

1985-02-01

The radiological development from normal bone of geodes and subsequent fractures in phalanges of two adjacent fingers is described in a patient with classical rheumatoid arthritis. Presentation was as a septic, discharging focus, but infection was excluded; the pathology is described.

Automatic segmentation of bones from digital hand radiographs

NASA Astrophysics Data System (ADS)

Liu, Brent J.; Taira, Ricky K.; Shim, Hyeonjoon; Keaton, Patricia

1995-05-01

The purpose of this paper is to develop a robust and accurate method that automatically segments phalangeal and epiphyseal bones from digital pediatric hand radiographs exhibiting various stages of growth. The algorithm uses an object-oriented approach comprising several stages beginning with the most general objects to be segmented, such as the outline of the hand from background, and proceeding in a succession of stages to the most specific object, such as a specific phalangeal bone from a digit of the hand. Each stage carries custom operators unique to the needs of that specific stage which will aid in more accurate results. The method is further aided by a knowledge base where all model contours and other information such as age, race, and sex, are stored. Shape models, 1-D wrist profiles, as well as an interpretation tree are used to map model and data contour segments. Shape analysis is performed using an arc-length orientation transform. The method is tested on close to 340 phalangeal and epiphyseal objects to be segmented from 17 cases of pediatric hand images obtained from our clinical PACS. Patient age ranges from 2 - 16 years. A pediatric radiologist preliminarily assessed the results of the object contours and were found to be accurate to within 95% for cases with non-fused bones and to within 85% for cases with fused bones. With accurate and robust results, the method can be applied toward areas such as the determination of bone age, the development of a normal hand atlas, and the characterization of many congenital and acquired growth diseases. Furthermore, this method's architecture can be applied to other image segmentation problems.

Hardness map of human meta tarsals and phalanges of toes.

PubMed

Manarvi, Irfan

2016-08-01

Predicting location of fracture in human bones has been a keen area of research for the past few decades. A variety of tests for hardness, deformation and strain field measurement have been conducted in the past; but considered insufficient due to various limitations. Researchers therefore have proposed further studies due to inaccuracies in measurement methods, testing machines and experimental errors. Advancement and availability of hardware, measuring instrumentation and testing machines can now provide remedies to these limitations. Human foot is a critical part of body exposed to various forces throughout its life. A number of products are developed for using over it for protection and care. Which many times do not provide sufficient protection and may itself become a source of stress due to non-consideration of the delicacy of bones in the feet. A continuous strain or overloading on feet may occur resulting to discomfort and even fracture. Not knowing how the hardness is spread all over the Meta tarsals and phalanges is one of major contributory factor for unsatisfactory design of foot protection products. This paper provides a complete hardness distribution map developed by experimental testing of all the Meta tarsals and Phalanges of toes for a typical human foot. The bones were taken from two left feet of a 40 and 42 year old male cadaver. These were dehydrated prior to measurements of hardness using Leeb hardness testing method. Hardness was measured around the circumference of a bone as well as along its length. Hardness values can be related to tensile strength of the bones to predict possible values of stress that could be borne by these bones. Results may also be used for design and developing various accessories for human feet health care and comfort.

Competitive Swimming and Handball Participation Have a Positive Influence on Bone Parameters as Assessed by Phalangeal Quantitative Ultrasound in Female Adolescents.

PubMed

Krahenbuhl, Tathyane; Gonçalves, Ezequiel M; Guimarães, Roseane Fatima; Guerra-Junior, Gil; Barros-Filho, Antonio

2016-08-01

To examine the influence of participation in competitive sports on bone parameters, as assessed by quantitative ultrasound (QUS) of the phalanges in female adolescents. Female adolescents (n = 329, 13.0-16.7 years old) were classified into handball (n = 55), swimming (n = 49) and control (n = 225) groups. QUS was used to evaluate the amplitude-dependent speed of sound (AD-SoS) and bone transmission time (BTT), and their z-scores (zAD-SoS and zBTT) were calculated. Anthropometric measurements and Tanner's stages were also obtained. Swimmers had higher AD-SoS (2089 ± 43.8 m/s) and zAD-SoS (0.47 ± 0.8) than controls (2060 ± 54.0 m/s; 0.09 ± 1.0; both p ≤ .05) and both groups of athletes had higher BTT (handball: 1.44 ± 0.2 μs; swimming: 1.45 ± 0.2) and zBTT (handball: 0.71 ± 0.8; swimming: 0.72 ± 1.1) than the control group (1.37 ± 0.2 μs; 0.32 ± 0.9; all p ≤ .05). Swimmers had a higher total training time (TTT: 52.5 ± 27.6 months) and frequency of training per week (FT: 5.38 ± 0.1) compared with the handball group (35.9 ± 18.1; 3.32 ± 0.8; p ≤ .05). zAD-SoS, BTT and zBTT were positively correlated with FT, while BTT and zBTT showed a positive correlation with TTT. Sports practice influences bone parameters and higher bone parameter values are related to the amount of time and frequency of weekly training. The differences in phalangeal QUS parameters are independent of the impact of weight-bearing exercise.

Short stature Revealing a Pycnodysostosis: A Case Report

PubMed Central

Aynaou, Hayat; Skiker, Imane; Latrech, Hanane

2016-01-01

Introduction: Pycnodysostosis is a rare genetic disease characterized by osteosclerosis and bone fragility. The clinical aspects are varied including short stature, acro-osteolysis of distal phalanges, and dysplasia of the clavicles. Oral and maxillofacial manifestations of this disease are very clear. The head is usually large, a beaked nose, obtuse mandibular angle, and both maxilla and mandible are hypoplastic. Dental abnormalities are common. We report a case with the typical clinical and radiological characteristics of the Pycnodysostosis associated with a conductive hearing loss, an association rarely reported. Case Presentation: A 12-year-female was admitted in our institute for short stature with a dysmorphic facies for evaluation. The patient reported a history of multiple fractures of the long bones after a trivial fall. On physical examination, she had the following features: short stature, limited mouth opening, short hands and feet with dysplastic nails; frontal and occipital bossing; and hypoplasia of the maxilla and mandible. Examination of the mouth: grooved palate, caries of the teeth, impacted and malposed teeth, persistent deciduous teeth and missing teeth. Laboratory investigations were normal. The radiographic examination showed a generalized increase in the bone density, slight condensation of the skull base and a very open mandibular angle. X-rays showed tapered phalanges with acro-osteolysis of the distal phalanges. A symptomatic treatment was proposed based on fracture prevention, oral hygiene, frequent dental visits and psychiatric support. Conclusion: The clinical and radiological features are the bases for the diagnosis of this disease. It is important to make the diagnosis as early as possible in order to plan the treatment and to provide a better life quality to the patients. PMID:27703936

Geode development and multiple fractures in rheumatoid arthritis.

PubMed Central

Lowthian, P J; Calin, A

1985-01-01

The radiological development from normal bone of geodes and subsequent fractures in phalanges of two adjacent fingers is described in a patient with classical rheumatoid arthritis. Presentation was as a septic, discharging focus, but infection was excluded; the pathology is described. Images PMID:3977410

[Treatment of fractures of proximal phalanx of fingers by Eiffel Tower percutaneous pinning method. A review of 45 cases].

PubMed

Chbani, B; Amar, M F; Loudyi, D; Boutayeb, F

2010-04-01

The authors report in the treatment of fractures of the proximal phalanx of the fingers, the use of Eiffel Tower pinning, a relatively simple method, fast and stable, associated to a protection and early rehabilitation. The objective of this method is to offer to the patient a pollici-digital grip. Our study is a retrospective study of 45 patients treated for fractures of the proximal phalanx of the fingers by percutaneous pinning according to Eiffel Tower method. We detail this simple and economic technique and examine the functional and radiological results of this series of patients. The amplitude of the active total motion of the proximal interphalangeal joint is on average 94.16 degrees (78.5 % of the normal active mobility of the proximal interphalangeal joint), and the amplitude of the active total motion of the metacarpo-phalangeal joint is on average 90.05 degrees (75 % of the normal active mobility of the metacarpo-phalangeal joint). Copyright 2010 Elsevier Masson SAS. All rights reserved.

Kirschner wire pin tract infection rates between percutaneous and buried wires in treating metacarpal and phalangeal fractures.

PubMed

Rafique, Atif; Ghani, Shahab; Sadiq, Moiz; Siddiqui, Intisar Ahmed

2006-08-01

To compare pin tract infection rate between percutaneous and buried placement of Kirschner (K-) wiring for hand fractures. Quasi--experimental study. Plastic, Reconstructive, Hand and Burn Surgery Unit, Liaquat National Hospital, Karachi, from September 2005--February 2006. Patients with fractures of metacarpals and phalanges of hand were selected by non-probability purposive method. Assessment of pin tract infection by clinical examination and pin tract scoring was done by modification of Oppenheim classification. Statistical analysis was done using Chi-square test. Ten out of 55 percutaneous and 2 out of 45 buried wires were infected. The difference in infection rates of two groups was statistically significant at p<0.05. Three percutaneous, but not buried Kirschner wires, had to be removed before 4 weeks because of failure to respond to local wound care and oral antibiotics. Percutaneous K- wires had significantly greater infection rate than wires which were buried deep to the skin.

Training giraffe (Giraffa camelopardalis reticulata) for front foot radiographs and hoof care.

PubMed

Dadone, Liza I; Schilz, Amy; Friedman, Susan G; Bredahl, Jason; Foxworth, Steve; Chastain, Bob

2016-05-01

For a large herd of reticulated giraffes, a mainly operant-based training program was created for front foot radiographs and hoof trims in an effort to diagnose and better manage lameness. Behaviors were shaped in a restricted contact set-up, using a positive reinforcement procedure to teach a series of mastered cued behaviors. This training was used to obtain lateral and lateral oblique front foot radiographs for the entire herd. Radiographs were diagnostic for multiple possible causes of lameness including fractures and osteitis of the distal phalangeal bone, hoof overgrowth, osteoarthritis of the distal interphalangeal joint, rotation of the distal phalangeal bone, sesamoid bone cysts, and sole foreign bodies. By training giraffe for foot radiographs and hoof trims, potential causes of lameness could be identified and better managed. Long-term, the results may help zoos identify best practices for managing and preventing lameness in giraffe. Zoo Biol. 35:228-236, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Analogous cellular contribution and healing mechanisms following digit amputation and phalangeal fracture in mice

PubMed Central

Dawson, Lindsay A.; Simkin, Jennifer; Sauque, Michelle; Pela, Maegan; Palkowski, Teresa

2016-01-01

Abstract Regeneration of amputated structures is severely limited in humans and mice, with complete regeneration restricted to the distal portion of the terminal phalanx (P3). Here, we investigate the dynamic tissue repair response of the second phalangeal element (P2) post amputation in the adult mouse, and show that the repair response of the amputated bone is similar to the proximal P2 bone fragment in fracture healing. The regeneration‐incompetent P2 amputation response is characterized by periosteal endochondral ossification resulting in the deposition of new trabecular bone, corresponding to a significant increase in bone volume; however, this response is not associated with bone lengthening. We show that cells of the periosteum respond to amputation and fracture by contributing both chondrocytes and osteoblasts to the endochondral ossification response. Based on our studies, we suggest that the amputation response represents an attempt at regeneration that ultimately fails due to the lack of a distal organizing influence that is present in fracture healing. PMID:27499878

Prediction of hip fracture risk by quantitative ultrasound in more than 7000 Swiss women > or =70 years of age: comparison of three technologically different bone ultrasound devices in the SEMOF study.

PubMed

Krieg, Marc-Antoine; Cornuz, Jacques; Ruffieux, Christiane; Van Melle, Guy; Büche, Daniel; Dambacher, Maximilian A; Hans, Didier; Hartl, Florian; Häuselmann, Hansjorg J; Kraenzlin, Marius; Lippuner, Kurt; Neff, Maurus; Pancaldi, Pierro; Rizzoli, Rene; Tanzi, Franco; Theiler, Robert; Tyndall, Alan; Wimpfheimer, Claus; Burckhardt, Peter

2006-09-01

To compare the prediction of hip fracture risk of several bone ultrasounds (QUS), 7062 Swiss women > or =70 years of age were measured with three QUSs (two of the heel, one of the phalanges). Heel QUSs were both predictive of hip fracture risk, whereas the phalanges QUS was not. As the number of hip fracture is expected to increase during these next decades, it is important to develop strategies to detect subjects at risk. Quantitative bone ultrasound (QUS), an ionizing radiation-free method, which is transportable, could be interesting for this purpose. The Swiss Evaluation of the Methods of Measurement of Osteoporotic Fracture Risk (SEMOF) study is a multicenter cohort study, which compared three QUSs for the assessment of hip fracture risk in a sample of 7609 elderly ambulatory women > or =70 years of age. Two QUSs measured the heel (Achilles+; GE-Lunar and Sahara; Hologic), and one measured the heel (DBM Sonic 1200; IGEA). The Cox proportional hazards regression was used to estimate the hazard of the first hip fracture, adjusted for age, BMI, and center, and the area under the ROC curves were calculated to compare the devices and their parameters. From the 7609 women who were included in the study, 7062 women 75.2 +/- 3.1 (SD) years of age were prospectively followed for 2.9 +/- 0.8 years. Eighty women reported a hip fracture. A decrease by 1 SD of the QUS variables corresponded to an increase of the hip fracture risk from 2.3 (95% CI, 1.7, 3.1) to 2.6 (95% CI, 1.9, 3.4) for the three variables of Achilles+ and from 2.2 (95% CI, 1.7, 3.0) to 2.4 (95% CI, 1.8, 3.2) for the three variables of Sahara. Risk gradients did not differ significantly among the variables of the two heel QUS devices. On the other hand, the phalanges QUS (DBM Sonic 1200) was not predictive of hip fracture risk, with an adjusted hazard risk of 1.2 (95% CI, 0.9, 1.5), even after reanalysis of the digitalized data and using different cut-off levels (1700 or 1570 m/s). In this elderly women population, heel QUS devices were both predictive of hip fracture risk, whereas the phalanges QUS device was not.

Bone indicators of grasping hands in lizards

PubMed Central

2016-01-01

Grasping is one of a few adaptive mechanisms that, in conjunction with clinging, hooking, arm swinging, adhering, and flying, allowed for incursion into the arboreal eco-space. Little research has been done that addresses grasping as an enhanced manual ability in non-mammalian tetrapods, with the exception of studies comparing the anatomy of muscle and tendon structure. Previous studies showed that grasping abilities allow exploitation for narrow branch habitats and that this adaptation has clear osteological consequences. The objective of this work is to ascertain the existence of morphometric descriptors in the hand skeleton of lizards related to grasping functionality. A morphological matrix was constructed using 51 morphometric variables in 278 specimens, from 24 genera and 13 families of Squamata. To reduce the dimensions of the dataset and to organize the original variables into a simpler system, three PCAs (Principal Component Analyses) were performed using the subsets of (1) carpal variables, (2) metacarpal variables, and (3) phalanges variables. The variables that demonstrated the most significant contributions to the construction of the PCA synthetic variables were then used in subsequent analyses. To explore which morphological variables better explain the variations in the functional setting, we ran Generalized Linear Models for the three different sets. This method allows us to model the morphology that enables a particular functional trait. Grasping was considered the only response variable, taking the value of 0 or 1, while the original variables retained by the PCAs were considered predictor variables. Our analyses yielded six variables associated with grasping abilities: two belong to the carpal bones, two belong to the metacarpals and two belong to the phalanges. Grasping in lizards can be performed with hands exhibiting at least two different independently originated combinations of bones. The first is a combination of a highly elongated centrale bone, reduced palmar sesamoid, divergence angles above 90°, and slender metacarpal V and phalanges, such as exhibited by Anolis sp. and Tropidurus sp. The second includes an elongated centrale bone, lack of a palmar sesamoid, divergence angles above 90°, and narrow metacarpal V and phalanges, as exhibited by geckos. Our data suggest that the morphological distinction between graspers and non-graspers is demonstrating the existence of ranges along the morphological continuum within which a new ability is generated. Our results support the hypothesis of the nested origin of grasping abilities within arboreality. Thus, the manifestation of grasping abilities as a response to locomotive selective pressure in the context of narrow-branch eco-spaces could also enable other grasping-dependent biological roles, such as prey handling. PMID:27168987

A Study to Determine the Best Method of Caring for Certain Short-Stay Surgical Patients at Reynolds Army Community Hospital

DTIC Science & Technology

1988-09-01

Perineoplasty Vaginal cyst, cautery Vaginal web, excision Surgical Patients 95 ORTHOPEDIC Arthrodesis of phalanges Arthroscopy Bone biopsy Bunionectomy...Manipulation of shoulder, knee, or hip Mass excision with scar revision Meniscectomy (if done through arthroscopy ) Metatarsal head, excision unilateral

Pseudohypoparathyroidism vs. tricho-rhino-phalangeal syndrome: patient reclassification.

PubMed

Pereda, Arrate; Azriel, Sharona; Bonet, Mariona; Garin, Intza; Gener, Blanca; Lecumberri, Beatriz; de Nanclares, Guiomar Pérez

2014-11-01

Given that tricho-rhino-phalangeal syndrome (TRPS) and pseudohypoparathyroidism/pseudopseudohypoparathyroidism (PHP/PPHP) are very rare monogenic disorders that share some features (distinctive facies, short stature, brachydactyly and, in some patients, intellectual disability) that lead to their misdiagnosis in some cases, our objective was to identify clinical, biochemical or radiological signs that could help to distinguish these two syndromes. We report on two cases, which were referred to the Endocrinology and Pediatric Endocrinology Services for obesity. Clinical evaluation initially suggested the diagnosis of PHP-Ia [phenotype suggestive of Albright hereditary osteodystrophy (AHO) with parathyroid hormone (PTH) resistance] and PPHP (phenotype resembling AHO, without PTH resistance), but (epi)genetic analysis of the GNAS locus ruled out the suspected diagnosis. Further clinical re-evaluation prompted us to suspect TRPS, and this was confirmed genetically. TRPS was mistakenly identified as PHP/PPHP because of the coexistence of obesity and brachydactyly, with PTH resistance in one of the cases. Specific traits such as sparse scalp hair and a pear-shaped nose, present in both cases, can be considered pathognomonic signs of TRPS, which could help us to reach a correct diagnosis.

New modified technique of osteotomy for hallux valgus.

PubMed

Oh, I S; Kim, M K; Lee, S H

2004-12-01

To improve the technique of osteotomy for hallux valgus (bunion). 38 cases of a new modified osteotomy procedure for hallux valgus were performed for 22 patients (21 women and one man). During a 3-year (range, 2-5 years) follow-up, the patients underwent physical examination; and their American Orthopedic Foot and Ankle Society hallux-metatarso-phalangeal-interphalangeal scale scores and standard foot radiographic measurements were recorded. 20 of the 22 patients (38 cases) had no pain, achieved good cosmesis, and were completely satisfied with the results of the operation. The remaining 2 patients had occasional mild discomfort. The mean hallux-metatarso-phalangeal-interphalangeal scale score was 93 points (range, 78-100 points). The mean preoperative and postoperative metatarsophalangeal angles were 34 degrees and 11 degrees, respectively. The mean postoperative reduction of the intermetatarsal angle and metatarsophalangeal angle were 6 degrees and 23 degrees, respectively. The new technique of osteotomy achieved even greater stability and accurate correction of the deformity in our 38 cases. Furthermore, it was more effective than conventional 'chevron' osteotomy in terms of correction of the deformity. Therefore, it should be used more widely.

Pedal proportions of Poposaurus gracilis: convergence and divergence in the feet of archosaurs.

PubMed

Farlow, James O; Schachner, Emma R; Sarrazin, John Cody; Klein, Hendrik; Currie, Philip J

2014-06-01

The crocodile-line basal suchian Poposaurus gracilis had body proportions suggesting that it was an erect, bipedal form like many dinosaurs, prompting questions of whether its pedal proportions, and the shape of its footprint, would likewise "mimic" those of bipedal dinosaurs. We addressed these questions through a comparison of phalangeal, digital, and metatarsal proportions of Poposaurus with those of extinct and extant crocodile-line archosaurs, obligate or facultatively bipedal non-avian dinosaurs, and ground birds of several clades, as well as a comparison of the footprint reconstructed from the foot skeleton of Poposaurus with known early Mesozoic archosaurian ichnotaxa. Bivariate and multivariate analyses of phalangeal and digital dimensions showed numerous instances of convergence in pedal morphology among disparate archosaurian clades. Overall, the foot of Poposaurus is indeed more like that of bipedal dinosaurs than other archosaur groups, but is not exactly like the foot of any particular bipedal dinosaur clade. Poposaurus likely had a digitigrade stance, and its footprint shape could have resembled grallatorid ichnotaxa, unless digit I of the foot of Poposaurus commonly left an impression. Copyright © 2014 Wiley Periodicals, Inc.

Rare case of tibial hemimelia, preaxial polydactyly, and club foot

PubMed Central

Granite, Guinevere; Herzenberg, John E; Wade, Ronald

2016-01-01

A seven-month old female presented with left tibial hemimelia (or congenital tibial aplasia; Weber type VIIb, Jones et al type 1a), seven-toed preaxial polydactyly, and severe club foot (congenital talipes equinovarus). Definitive amputation surgery disarticulated the lower limb at the knee. This case report describes the anatomical findings of a systematic post-amputation examination of the lower limb’s superficial dissection, X-rays, and computed tomography (CT) scans. From the X-rays and CT scans, we found curved and overlapping preaxial supernumerary toes, hypoplastic first metatarsal, lack of middle and distal phalanges in one supernumerary toe, three tarsal bones, hypoplastic middle phalanx and no distal phalanx for fourth toe, and no middle or distal phalanges for fifth toe. The fibula articulated with the anteromedial calcaneus and the tibia was completely absent. We identified numerous muscles and nerves in the superficial dissection that are described in the results section of the case report. Due to the rarity of this combination of anatomical findings, descriptions of such cases are very infrequent in the literature. PMID:28035313

Rare case of tibial hemimelia, preaxial polydactyly, and club foot.

PubMed

Granite, Guinevere; Herzenberg, John E; Wade, Ronald

2016-12-16

A seven-month old female presented with left tibial hemimelia (or congenital tibial aplasia; Weber type VIIb, Jones et al type 1a), seven-toed preaxial polydactyly, and severe club foot (congenital talipes equinovarus). Definitive amputation surgery disarticulated the lower limb at the knee. This case report describes the anatomical findings of a systematic post-amputation examination of the lower limb's superficial dissection, X-rays, and computed tomography (CT) scans. From the X-rays and CT scans, we found curved and overlapping preaxial supernumerary toes, hypoplastic first metatarsal, lack of middle and distal phalanges in one supernumerary toe, three tarsal bones, hypoplastic middle phalanx and no distal phalanx for fourth toe, and no middle or distal phalanges for fifth toe. The fibula articulated with the anteromedial calcaneus and the tibia was completely absent. We identified numerous muscles and nerves in the superficial dissection that are described in the results section of the case report. Due to the rarity of this combination of anatomical findings, descriptions of such cases are very infrequent in the literature.

Radiographic anatomy of the foot and ankle-part 5. The phalanges.

PubMed

Christman, Robert A

2015-03-01

The normal radiographic anatomy of the foot and ankle, aside from my previous work, has been addressed only superficially or sparingly in the medical literature. This project correlates the detailed radiographic anatomy of the entire adult foot and ankle (two-dimensional) to osteology (three-dimensional). Each bone's position was determined after meticulous examination and correlation to an articulated skeleton relative to the image receptor and direction of the x-ray beam, with correlation to the radiograph for confirmation. Images of each foot and distal leg bone ("front" and "back" perspectives) are presented alongside a corresponding radiographic image for comparison. The normal gross and radiographic anatomy is correlated and described for each radiographic positioning technique. Foundational knowledge is provided that future researchers can use as a baseline ("normal") and that students and practitioners can use for comparison when interpreting radiographs and distinguishing abnormal findings. The results of the original project, owing to its broad scope, have been divided into five parts: the lower leg, the greater tarsus, the lesser tarsus, the metatarsals, and the phalanges (the focus of this article).

Simplicity and treatment of the typical cleft hand.

PubMed

Upton, J

2004-01-01

The typical cleft hand is now distinguished from symbrachydactyly. This review of the surgical treatment of 108 hands in 63 patients treated over a 28-year period concentrates upon the technical principles of surgical correction. The key to these reconstructions is a wide incision which extends from the ulnar side of the cleft around the malpositioned index finger to the thumb. This wide exposure provides clear identification of all anatomic structures within the palm. There are no tenuous flaps with narrow random pedicles. These difficult surgical corrections may often include index transposition, metacarpal and/or phalangeal osteotomies, joint releases, phalangeal ostectomies, preservation of the adductor pollicis muscle, first dorsal interosseous muscle release, syndactyly separation(s) and thumb duplication correction. Following reposition of all skeletal structures the dorsal and palmar full-thickness flaps are easily contoured to create a satisfactory first webspace. Outcomes data shows that although the pinch and grip remain weak, these hands are quite functional. It is important that the repositioned index ray not interfere with gripping and precision maneuvers between the mobile thumb and the ulnar two digits (ring and small) of the hand.

Extra-articular fractures of the digital metacarpals and phalanges of the long fingers.

PubMed

Le Nen, D

2014-02-01

Metacarpal and phalangeal fractures of the long fingers are the result of trauma occurring under extremely varied circumstances. As a consequence, the clinical presentation varies greatly, with every bone and joint potentially being involved. Each step of their treatment is crucial, although the benign appearance of these injuries can lead to steps being missed: diagnostic phase with clinical examination and radiographs; therapeutic phase where the most suitable treatment is chosen, which combines mobilization of the digital chains as soon as possible and in every patient; follow-up phase with regular monitoring to detect any complications, especially secondary displacement, and verify that good progress is being made during rehabilitation. The goal of any fracture treatment is to preserve or restore the anatomy, with the emphasis here being on the stability and mobility of the digital chains. The potential progression towards serious functional sequelae (pain, instability or stiffness in hand) and the resulting significant socio-economic repercussions must be at the forefront of a surgeon's mind early on during the initial care of any finger or hand trauma. Copyright © 2014. Published by Elsevier SAS.

Does the thickening of Achilles tendon and plantar fascia contribute to the alteration of diabetic foot loading?

PubMed

Giacomozzi, C; D'Ambrogi, E; Uccioli, L; Macellari, V

2005-06-01

The diabetic foot often undergoes abnormal plantar pressures, changing in walking strategy, ulcerative processes. The present study focuses on the effects that diabetes-induced alterations of Achilles tendon, plantar fascia and first metatarso-phalangeal joint-both anatomical and functional-may have on foot loading. Sixty-one diabetic patients, with or without neuropathy, and 21 healthy volunteers were recruited. Thickness of Achilles tendon and plantar fascia was measured by ultrasound. Flexion-extension of the first metatarso-phalangeal joint was measured passively. Main biomechanic parameters of foot-floor interaction during gait were acquired and related to the above measurements. Plantar fascia and Achilles tendon were significantly (P<0.05) thicker in diabetics than in controls; mean values (SD) for controls, diabetics without and with neuropathy were 2.0 mm (0.5), 2.9 mm (1.2) and 3.0 mm (0.8) for plantar fascia, respectively, and 4.0 mm (0.5), 4.6 mm (1.0) and 4.9 mm (1.7) for Achilles tendon, respectively. Flexion-extension of the first metatarso-phalangeal joint was significantly (P<0.05) smaller in diabetics than in controls; mean values (SD) for controls, diabetics without and with neuropathy were 100.0 degrees (10.0), 54.0 degrees (29.4) and 54.9 degrees (17.2), respectively. The increase in the vertical force under the metatarsals was strongly related (R=0.83, explained variance=70.1%) to the changes in the three above parameters. Thickening of plantar fascia and Achilles tendon in diabetics, more evident in the presence of neuropathy, concurs to develop a rigid foot, which poorly absorbs shock during landing (performs the physiological impact force absorption during landing). More generally, an overall alteration of the foot-ankle complex motion likely occurs throughout the whole gait cycle, which partly explains the abnormal loading under the forefoot.

Connective Tissue Fibroblast Properties Are Position-Dependent during Mouse Digit Tip Regeneration

PubMed Central

Wu, Yuanyuan; Wang, Karen; Karapetyan, Adrine; Fernando, Warnakulusuriya Akash; Simkin, Jennifer; Han, Manjong; Rugg, Elizabeth L.; Muneoka, Ken

2013-01-01

A key factor that contributes to the regenerative ability of regeneration-competent animals such as the salamander is their use of innate positional cues that guide the regeneration process. The limbs of mammals has severe regenerative limitations, however the distal most portion of the terminal phalange is regeneration competent. This regenerative ability of the adult mouse digit is level dependent: amputation through the distal half of the terminal phalanx (P3) leads to successful regeneration, whereas amputation through a more proximal location, e.g. the subterminal phalangeal element (P2), fails to regenerate. Do the connective tissue cells of the mammalian digit play a role similar to that of the salamander limb in controlling the regenerative response? To begin to address this question, we isolated and cultured cells of the connective tissue surrounding the phalangeal bones of regeneration competent (P3) and incompetent (P2) levels. Despite their close proximity and localization, these cells show very distinctive profiles when characterized in vitro and in vivo. In vitro studies comparing their proliferation and position-specific interactions reveal that cells isolated from the P3 and P2 are both capable of organizing and differentiating epithelial progenitors, but with different outcomes. The difference in interactions are further characterized with three-dimension cultures, in which P3 regenerative cells are shown to lack a contractile response that is seen in other fibroblast cultures, including the P2 cultures. In in vivo engraftment studies, the difference between these two cell lines is made more apparent. While both P2 and P3 cells participated in the regeneration of the terminal phalanx, their survival and proliferative indices were distinct, thus suggesting a key difference in their ability to interact within a regeneration permissive environment. These studies are the first to demonstrate distinct positional characteristics of connective tissue cells that are associated with their regenerative capabilities. PMID:23349966

Detection of a megabase deletion in a patient with brachio-oto-renal syndrome (BOR) and tricho-rhino-phalangeal syndrome (TRPS): Implications for mapping and cloning the BOR gene

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gu, J.Z.; Wells, D.E.; Wagner, M.J.

Genetic linkage analysis has previously mapped the locus for the autosomal dominant disorder branchio-oto-renal syndrome (BOR) to the pericentric region of chromosome 8q. A YAC contig spanning the putative BOR region, from D8S543 to D8S541, was constructed and confirmed by sequence-tagged site content mapping using microsatellite markers and by DNA hybridization analysis. YACs spanning the BOR interval were used as fluorescence in situ hybridization probes on a cell line from a patient with BO and tricho-rhino-phalangeal syndrome I that involves a chromosome 8q rearrangement. In addition to the cytogenetically defined direct insertion of material from 8q13.3-q21.13 into 8q24.11, a previouslymore » unidentified deletion of just under one megabase was found in 8q13.3. These data narrowed the most likely location of the BOR gene to a region corresponding to the proximal two-thirds of YAC 869E10 between D8S543 and D8S279. 23 refs., 3 figs.« less

Case report: severe melorheostosis involving the ipsilateral extremities.

PubMed

Long, Hai-Tao; Li, Kang-Hua; Zhu, Yong

2009-10-01

Melorheostosis is a rare, noninheritable bone dysplasia characterized by its classic radiographic feature of flowing hyperostosis resembling dripping candle wax, generally on one side of the long bone. The condition originally was described by Leri and Joanny in 1922. Its etiology remains speculative, and treatment in most instances has been symptomatic. Melorheostosis usually affects one limb, more often the lower extremity, and rarely the axial skeleton. We report a rare case of severe melorheostosis in the ipsilateral upper and lower extremities with normal contralateral extremities. The plain radiographs revealed almost all the bones in the affected extremities, from clavicle and scapula to distal phalanges of the fingers and from femur to distal phalanges of the toes, presented extensive, dense hyperostosis and heterotopic ossification in the periarticular soft tissue. Physical examination showed considerable swelling and deformities of the left limbs, stiffness and distortion of the joints, and anesthesia in the left ulnar regions of the forearm and hand. The examination of the right side was normal. Computed tomography scans showed multiple areas of classic candle wax-like hyperostosis and narrowing or disappearance of the medullary cavity. Histologic analysis confirmed the clinical and imaging diagnosis and revealed extremely dense sclerotic bone of cortical pattern.

[Carpal bones of the Chiroptera in the comparative-anatomical and functional aspects].

PubMed

Manziĭ, S F; Kovtun, M F

1977-09-01

Data on investigation of hand sceletal bones carried out in eight genera of three families of bats were subjected to comparative-anatomical and functional analysis. Quantitatively, the hand sceletal bones of Chiroptera preserve constructive pattern general for the hand of terrestrial mammalians Pentadactilus. It has rudiments of the prefirst (Pp) and the seventh (Pm) rays. The latter is situated on the volar surface of the base Mc5. Scaphoid, semilunar and central carnal bones of Chiroptera, like those of Mototremata, some Marsupialia, Insectivorona and Carnivora merge together into one large bone--os lunatum. At the same time, the hand of Chiropter is a highly specialized structure, that is evident from the presence of articular restricotrs of anterior sagging of the wrist, crests and grooves directing movements in a strictly definite plane, from fan-like spreading and bringing together the rays, from very long metacarpal bones and proximal phalanges, from reduction of distal phalangs of the 3d and 5th fingers. Thus, the hand of Chiroptera is a unique example of combination of primitive, initial for pentadactule plantigrades wrist with signs of narrow specialization resembling, to some extent, those of Ungulata; only in Ungulata those signs developed on the base of digitigrades wrist.

A novel TRPS1 mutation in a Moroccan family with Tricho-rhino-phalangeal syndrome type III: case report.

PubMed

Smaili, W; Elalaoui, S Chafai; Meier, S; Zerkaoui, M; Sefiani, A; Heinimann, K

2017-05-03

Tricho-rhino-phalangeal syndrome (TRPS) is an autosomal dominant disorder characterized by craniofacial and skeletal malformations including short stature, thin scalp hair, sparse lateral eyebrows, pear-shaped nose and cone shaped epiphyses. This condition is caused by haploinsufficiency of the TRPS1 gene. Previous genotype-phenotype studies have correlated exon 6 missense mutations with TRPS type III, a severe form of type I with pronounced, facial characteristics, short stature and brachydactyly and differing from type II by the absence of exostoses and mental retardation. We report the first case of a Moroccan family, a father and his three children, in which the diagnosis of type III TRPS was suspected based on severe clinical and radiological features. Molecular analysis of the TRPS1 gene revealed a novel missense mutation in exon 6, (p.Ala932Ser), located in the GATA-type DNA-binding zinc finger domain. Our observations in this kindred support the previous genotype-phenotype results suggesting that patients with more pronounced facial characteristics and more severe shortening of hands and feet are more likely to have mutation in exon 6 of TRPS1.

[Bone ultrasonography in kidney disease: applications and limitations].

PubMed

Aucella, Filippo; Gesuete, Antonio; Cicchella, Antonio; Granata, Antonio; Fiorini, Fulvio; Guglielmi, Giuseppe

2012-01-01

Quantitative ultrasound (QUS) of the bone is a technique that is generating great interest among bone structure researchers because of its intrinsic features. Its safety and low cost make it an ideal technique for repeated measurements over time such as in chronic disease or when it is necessary to monitor the effects of prescribed therapies. The method was developed for the study of osteoporosis and the sites of measurement are all peripheral, including the distal diaphyses and metaphyses of the phalanges, calcaneus, radius and tibia. QUS parameters, however, cannot be used directly for the diagnosis of osteoporosis according to the WHO criteria, although many authors have shown that ultrasound parameters, particularly those of calcaneal QUS, can predict the risk of osteoporotic fractures independently of MBD. Very promising results with the use of QUS have been obtained in corticosteroid-induced osteoporosis, rheumatoid arthritis, Cushing's syndrome, cystic fibrosis, osteomalacia, thalassemia and osteopenia related to parenteral nutrition. QUS can also monitor the effectiveness of therapy in various pathological conditions. In nephrology the combined use of phalangeal QUS and biochemical markers of bone turnover allows adequate follow-up of patients on dialysis and renal transplant recipients with alterations or disorders of the bone.

Skeletal changes in lower limb bones in domestic cattle from Eketorp ringfort on the Öland island in Sweden.

PubMed

Telldahl, Ylva

2012-12-01

In this paper the nature and frequency of skeletal changes in the lower limb bones of cattle are investigated. The bones derive from the archaeological site of Eketorp ringfort on the Öland island in Sweden dated between Iron Age-Middle Age (ca. A.D. 300-1200/50). The analysis was conducted to explore whether skeletal lesions were associated with traction activity, and if changes in the type and prevalence of lesions occurred over time. Different skeletal lesions were recorded by bone and precise anatomical location: the joint surfaces of metapodia and phalanges were divided into four to seven zones to determine if different types of lesions were located on particular regions of the articular surface. The results show that metatarsals exhibited a higher frequency of pathologies in the Iron Age and medieval period compared to metacarpals, while anterior phalanges 1 and 2 had a higher occurrence of lesions than the posterior elements. The study also demonstrates that the type and location of depressions on joint surfaces are unevenly distributed between bone elements. Finally, the results show that skeletal lesions were more common in robust animals. Copyright © 2012 Elsevier Inc. All rights reserved.

[Hand and wrist bone maturation in children with central precocious puberty and idiopathic short stature].

PubMed

Wang, Anru; Yang, Fangling; Yu, Baosheng; Shan, Ye; Gao, Lanying; Zhang, Xiaoxiao; Peng, Ya

2013-07-01

To investigate the maturation of individual bones on the hand and wrist in children with central precocious puberty (CPP) and idiopathic short stature (ISS). Hand and wrist films of 25 children with CPP, 29 children with ISS and 21 normal controls were evaluated by conventional Greulich-Pyle (GP) atlas method and individual bone assessment method, in which all twenty bones of the hand and wrist were evaluated based on GP atlas, including 2 radius and ulna, 7 carpal bones, 11 metacarpal and phalangeal bones, the average bone age (BA) was calculated. The differences in groups were analyzed by independent samples t test. The differences between the two methods were analyzed by paired sample t test. The differences between BA and chronological age (CA) were analyzed by ROC with SPSS 17.0. Compared with the normal control group, the advance of BA in the CPP group was 0.70-2.26 y (1.48 ±0.78) by the GP atlas method, while that was 0.28-2.00 y(1.14 ±0.86) by the individual bone evaluation method. In all twenty bones, the advance of metacarpal and phalangeal BA was the greatest [0.34-2.06 y(1.2±0.86)]. In the ISS group,the delay of BA was 0.47-2.91 y(-1.69±1.22) by the GP atlas method, while that was 0.48-2.50 y (-1.49±1.01) by individual bone evaluation method.The delay of carpal BA was the greatest [0.59-2.73 y(-1.66±1.07)] in all twenty bones. In the ISS group and the normal control group, there were no statistic differences between the two methods. In the CPP group, statistic difference was found between two methods. There were no statistic differences for the areas under ROC curves between two methods. The advance of metacarpal and phalangeal BA is the greatest in CPP group and the delay of carpal BA is the greatest in ISS group.Both methods provide diagnostic information for bone age in CPP and ISS children.

Three-Dimensional Imaging of the Mouse Organ of Corti Cytoarchitecture for Mechanical Modeling

NASA Astrophysics Data System (ADS)

Puria, Sunil; Hartman, Byron; Kim, Jichul; Oghalai, John S.; Ricci, Anthony J.; Liberman, M. Charles

2011-11-01

Cochlear models typically use continuous anatomical descriptions and homogenized parameters based on two-dimensional images for describing the organ of Corti. To produce refined models based more closely on the actual cochlear cytoarchitecture, three-dimensional morphometric parameters of key mechanical structures are required. Towards this goal, we developed and compared three different imaging methods: (1) A fixed cochlear whole-mount preparation using the fluorescent dye Cellmask®, which is a molecule taken up by cell membranes and clearly delineates Deiters' cells, outer hair cells, and the phalangeal process, imaged using confocal microscopy; (2) An in situ fixed preparation with hair cells labeled using anti-prestin and supporting structures labeled using phalloidin, imaged using two-photon microscopy; and (3) A membrane-tomato (mT) mouse with fluorescent proteins expressed in all cell membranes, which enables two-photon imaging of an in situ live preparation with excellent visualization of the organ of Corti. Morphometric parameters including lengths, diameters, and angles, were extracted from 3D cellular surface reconstructions of the resulting images. Preliminary results indicate that the length of the phalangeal processes decreases from the first (inner most) to third (outer most) row of outer hair cells, and that their length also likely varies from base to apex and across species.

Variation in the myosoricine hand skeleton and its implications for locomotory behavior (Eulipotyphla: Soricidae)

USGS Publications Warehouse

Woodman, Neal; Stabile, Frank A.

2015-01-01

Substrate use and locomotory behavior of mammals are typically reflected in external characteristics of the forefeet, such as the relative proportions of the digits and claws. Although skeletal anatomy of the forefeet can be more informative than external characters, skeletons remain rare in systematic collections. This is particularly true for the Myosoricinae (Eulipotyphla: Soricidae), a small clade of African shrews that includes both ambulatory forest shrews (Myosorex) and semifossorial mole shrews (Surdisorex). Most species in this subfamily have restricted distributions, and their behavior and ecology are mostly unstudied. To better understand the potential range of locomotory behavior among myosoricines, we used digital x-rays to image and facilitate measuring the forefoot skeletons of 9 species. As a gauge of potential variation, we compared them with the ambulatory talpid Uropsilus (Talpidae) and the semifossorial talpid Neurotrichus. The hand morphologies of myosoricines show a graded range of potential substrate use between ambulatory and semifossorial. Some of these shrews exhibit adaptations for increased burrowing efficiency that are similar to those seen in talpids and other mammals, such as longer, broader distal phalanges and claws and shorter, wider metacarpals and proximal and middle phalanges. They also, however, have characteristics that are distinct from talpids, such as maintenance of forefoot asymmetry and an increased emphasis of ray III.

[Sarcoidosis of the skeleton. Review of the literature and case report. (author's transl)].

PubMed

Uehlinger, E; Wurm, K

1976-08-01

The frequency of sarcoidosis in the skeleton varies between 3 and 36%. Skeletal sarcoidosis is rare in early stages (Löfgren-syndrom), relatively frequent in late stages. The initial phase is characterized by the formation of miliary non-caseating epitheloid-cell granulomas in the bone marrow. The invasion of the bone marrow may either be tolerated by the bone tissue or it initiates a perifocal osteosclerosis or a osteolysis. Correspondingly the X-ray of the skeleton shows normal structure or focal osteosclerosis or osteolysis. Therefore in the first case the sarcoidosis cannot be identified by X-ray. Most frequent locations are the phalanges of the fingers and toes, less common the stem skelton (skull, vertebrae, pelvis) and very rare the long tubular bones. In most cases the skeletal sarcoidosis is well tolerated. Report of a case of osteosclerotic sarcoidosis of the pelvis of a 39-years old woman with generalized sarcoidosis which was diagnozed four years earlier. The X-rays of the phalanges were normal. The biopsy of the iliac crest shows miliary sarcoid granuloma of the bone marrow and accretion of lamellar bone on the surface of the bone trabeculi with a distinct mosaic pattern. Treatment with steroids during the following five years was ineffective.

An inversion involving the mouse Shh locus results in brachydactyly through dysregulation of Shh expression.

PubMed

Niedermaier, Michael; Schwabe, Georg C; Fees, Stephan; Helmrich, Anne; Brieske, Norbert; Seemann, Petra; Hecht, Jochen; Seitz, Volkhard; Stricker, Sigmar; Leschik, Gundula; Schrock, Evelin; Selby, Paul B; Mundlos, Stefan

2005-04-01

Short digits (Dsh) is a radiation-induced mouse mutant. Homozygous mice are characterized by multiple defects strongly resembling those resulting from Sonic hedgehog (Shh) inactivation. Heterozygous mice show a limb reduction phenotype with fusion and shortening of the proximal and middle phalanges in all digits, similar to human brachydactyly type A1, a condition caused by mutations in Indian hedgehog (IHH). We mapped Dsh to chromosome 5 in a region containing Shh and were able to demonstrate an inversion comprising 11.7 Mb. The distal breakpoint is 13.298 kb upstream of Shh, separating the coding sequence from several putative regulatory elements identified by interspecies comparison. The inversion results in almost complete downregulation of Shh expression during E9.5-E12.5, explaining the homozygous phenotype. At E13.5 and E14.5, however, Shh is upregulated in the phalangeal anlagen of Dsh/+ mice, at a time point and in a region where WT Shh is never expressed. The dysregulation of Shh expression causes the local upregulation of hedgehog target genes such as Gli1-3, patched, and Pthlh, as well as the downregulation of Ihh and Gdf5. This results in shortening of the digits through an arrest of chondrocyte differentiation and the disruption of joint development.

An inversion involving the mouse Shh locus results in brachydactyly through dysregulation of Shh expression

PubMed Central

Niedermaier, Michael; Schwabe, Georg C.; Fees, Stephan; Helmrich, Anne; Brieske, Norbert; Seemann, Petra; Hecht, Jochen; Seitz, Volkhard; Stricker, Sigmar; Leschik, Gundula; Schrock, Evelin; Selby, Paul B.; Mundlos, Stefan

2005-01-01

Short digits (Dsh) is a radiation-induced mouse mutant. Homozygous mice are characterized by multiple defects strongly resembling those resulting from Sonic hedgehog (Shh) inactivation. Heterozygous mice show a limb reduction phenotype with fusion and shortening of the proximal and middle phalanges in all digits, similar to human brachydactyly type A1, a condition caused by mutations in Indian hedgehog (IHH). We mapped Dsh to chromosome 5 in a region containing Shh and were able to demonstrate an inversion comprising 11.7 Mb. The distal breakpoint is 13.298 kb upstream of Shh, separating the coding sequence from several putative regulatory elements identified by interspecies comparison. The inversion results in almost complete downregulation of Shh expression during E9.5–E12.5, explaining the homozygous phenotype. At E13.5 and E14.5, however, Shh is upregulated in the phalangeal anlagen of Dsh/+ mice, at a time point and in a region where WT Shh is never expressed. The dysregulation of Shh expression causes the local upregulation of hedgehog target genes such as Gli1-3, patched, and Pthlh, as well as the downregulation of Ihh and Gdf5. This results in shortening of the digits through an arrest of chondrocyte differentiation and the disruption of joint development. PMID:15841179

Space suit glove design with advanced metacarpal phalangeal joints and robotic hand evaluation.

PubMed

Southern, Theodore; Roberts, Dustyn P; Moiseev, Nikolay; Ross, Amy; Kim, Joo H

2013-06-01

One area of space suits that is ripe for innovation is the glove. Existing models allow for some fine motor control, but the power grip--the act of grasping a bar--is cumbersome due to high torque requirements at the knuckle or metacarpal phalangeal joint (MCP). This area in particular is also a major source of complaints of pain and injury as reported by astronauts. This paper explores a novel fabrication and patterning technique that allows for more freedom of movement and less pain at this crucial joint in the manned space suit glove. The improvements are evaluated through unmanned testing, manned testing while depressurized in a vacuum glove box, and pressurized testing with a robotic hand. MCP joint flex score improved from 6 to 6.75 (out of 10) in the final glove relative to the baseline glove, and torque required for flexion decreased an average of 17% across all fingers. Qualitative assessments during unpressurized and depressurized manned testing also indicated the final glove was more comfortable than the baseline glove. The quantitative results from both human subject questionnaires and robotic torque evaluation suggest that the final iteration of the glove design enables flexion at the MCP joint with less torque and more comfort than the baseline glove.

A new species of Bachia (Squamata: Gymnophthalmidae) with pleisomorphic limb morphology

USGS Publications Warehouse

Kizirian, D.A.; McDiarmid, R.W.

1998-01-01

We describe a new species of Bachia from the upper Rio Negro drainage of southeastern Colombia and southern Venezuela. The new taxon is diagnosed by a complement of phalanges that is unique among gymnophthalmid lizards and intermediate relative to other Bachia and closely related genera. Variation in limb osteology among the species of Bachia and close relatives is reported. We discuss the distribution of B. panoplia and the taxonomic status of B. flavescens.

Intrafamilial phenotypic heterogeneity of the Poland complex: a case report.

PubMed

Parano, E; Falsaperla, R; Pavone, V; Toscano, A; Bolan, E A; Trifiletti, R R

1995-08-01

Three cases of familial unilateral gluteal hypoplasia are reported. The index case in addition to having gluteal hypoplasia also has unilateral pectoral muscle hypoplasia. Another relative has unilateral symbrachydactyly of the distal phalanges of one foot. All four affected individuals in our pedigree were female. We propose that our cases are best classified as part of the Poland complex of anomalies. Our cases emphasize that intrafamilial phenotypic heterogeneity is possible within the Poland complex.

Classification and identification of inherited brachydactylies

PubMed Central

Fitch, Naomi

1979-01-01

A search for patterns of malformation in the brachydactylies has resulted in new ways to identify the different types. Type A-1 can be characterised by a proportionate reduction of the middle phalanges. Type B is thought to be an amputation-like defect. In type C the fourth middle phalanx is usually the longest, and type E (Riccardi and Holmes, 1974) is characterised by short metacarpals and short distal phalanges. Short stature is usually present in type A-1 and type E brachydactyly (Riccardi and Holmes, 1974) and it may be present in some individuals with brachydactyly C. As short children have short hands, it is possible that in patients with very mild expressions of brachydactyly the cause of the short stature may be overlooked. It is suggested that in every child with proportionate short stature the hands should be carefully examined. If the hands are disproportionately short, if any distal creases are missing, if there is a shortening, however mild, of any finger, if any metacarpals are short, then it is important to have ϰ-rays to look for brachydactyly A-1, C, or E. Much information is still needed. It is important in future reports to have skeletal surveys, pattern profile analyses, and to note the height of children with brachydactyly C. Most interesting of all will be when fetal limbs of each type become available for study. Images PMID:469884

How many entities exist for the spectrum of disorders associated with brachydactyly, syndactyly, short stature, microcephaly, and intellectual disability?

PubMed

Ravel, Aimé; Chouery, Eliane; Stora, Samantha; Jalkh, Nadine; Villard, Laurent; Temtamy, Samia; Mégarbané, André

2011-04-01

We describe a French young man with digital anomalies consisting of brachydactyly, F1-5 bilateral camptodactyly, interdigital webbing, F5 bilateral radial clinodactyly, and partial syndactyly of some fingers and toes. He had psychomotor retardation, short stature, umbilical hernia, a secundum atrial septal defect, seizures, hearing impairment, and dysmorphic features consisting of microcephaly, a prominent metopic ridge, upslanting palpebral fissures, synophrys, enophthalmia, large ears, a bulbous nose, a high palate, a smooth and short philtrum, a low hanging columella, a thin upper vermillion, an everted lower lip, prognathism, pectum excavatum, and supernumerary nipples. Osteotendinous reflexes were brisk. Mild nystagmus, myopia, and astigmatia were also noted. Total body X-rays showed short terminal phalanges of the hands, short middle phalanges of the index and little fingers, clinodactyly of the little fingers, short and fused proximal 4th and 5th metacarpals of the right hand, a short 5th metacarpal of the left hand, a fused left lunate-triquetrum, fused capitate-hamates, a prominent mandibula, and partial sacral agenesis. A thin posterior corpus callosum was apparent by MRI. Differential diagnoses for mainly the Rubinstein-Taybi syndrome, the Tsukahara syndrome, the Filippi syndrome, the Feingold syndrome, and the Tonoki syndrome are discussed, and the possibility that we might be reporting a novel entity is raised. © 2011 Wiley-Liss, Inc. Copyright © 2011 Wiley-Liss, Inc.

Osteosynthesis using plates and screws after removing a limited area of the periosteum in order to reduce misclassified during radiological assessment metacarpal shaft fractures

PubMed Central

Neagu, TP; Popescu, SA; Cobilinschi, C; Tincu, R; Tiglis, M; Lascar, I

2016-01-01

Hand fractures are one of the most common causes for presenting to the emergency room. Metacarpal fractures count about 18 to 44% of all hand fractures, and are most often standalone closed injuries, without misplacement, not needing operative treatment. We present a case in which osteosynthesis with plates and screws was used to reduce two metacarpal fractures in order to allow an early motion recovery, despite the fact that a small portion of the periosteum needed to be removed. The type of fractures were misclassified according to the radiological findings, therefore the correct diagnosis was established during surgery. The results according to the radiological aspects and to the DASH score were excellent with 95% function recovery at twelve months. In this case, the use of osteosynthesis with plates and screws led to a good fracture healing without any major complications. However, there are a series of complications related to this method that should be taken into consideration. Being misled by the radiological aspects of the fractures, the most certain way to classify a metacarpal shaft fracture is through exploratory surgery, even if in most of the cases the three radiological views are enough to establish the diagnosis. Abbreviations: DASH score = Disability of Arm, Shoulder and Hand score, TAM = Total Active Motion, MCP = metacarpal phalangeal joint, PIP = proximal inter phalangeal joint PMID:27974942

Computer-aided bone age assessment for ethnically diverse older children using integrated fuzzy logic system

NASA Astrophysics Data System (ADS)

Ma, Kevin; Moin, Paymann; Zhang, Aifeng; Liu, Brent

2010-03-01

Bone Age Assessment (BAA) of children is a clinical procedure frequently performed in pediatric radiology to evaluate the stage of skeletal maturation based on the left hand x-ray radiograph. The current BAA standard in the US is using the Greulich & Pyle (G&P) Hand Atlas, which was developed fifty years ago and was only based on Caucasian population from the Midwest US. To bring the BAA procedure up-to-date with today's population, a Digital Hand Atlas (DHA) consisting of 1400 hand images of normal children of different ethnicities, age, and gender. Based on the DHA and to solve inter- and intra-observer reading discrepancies, an automatic computer-aided bone age assessment system has been developed and tested in clinical environments. The algorithm utilizes features extracted from three regions of interests: phalanges, carpal, and radius. The features are aggregated into a fuzzy logic system, which outputs the calculated bone age. The previous BAA system only uses features from phalanges and carpal, thus BAA result for children over age of 15 is less accurate. In this project, the new radius features are incorporated into the overall BAA system. The bone age results, calculated from the new fuzzy logic system, are compared against radiologists' readings based on G&P atlas, and exhibits an improvement in reading accuracy for older children.

A rare presentation of flexor digitorum profundus type V avulsion injury with associated intra-articular fracture: A case report.

PubMed

Rizis, D; Mahoney, Jl

2011-01-01

Traumatic avulsions of the flexor digitorum profundus tendon are associated with young adults engaged in athletic activities such as football and rugby. The current report presents a case involving a 30-year-old man with traumatic avulsion of his flexor digitorum profundus and associated intra-articular distal phalangeal fracture secondary to injury during martial arts - an unusual cause of this injury. Increased attention to injuries acquired during this form of sporting activity is suggested.

The position of symbrachydactyly in the classification of congenital hand anomalies.

PubMed

Miura, T; Nakamura, R; Horii, E

1994-06-01

The clinical features of 53 cases of intercalated hypoplasia and 113 cases of distal aplasia are reviewed and compared with each other and with 129 cases of syndactyly. Tri-, di- and mono-phalangeal symbrachydactyly, and adactyly with nubbin digits are consecutive anomalies. Transverse deficiency may result if the mesenchyme is damaged severely, and if damage is mild and formation has continued, intercalated transverse deficiency may occur. Webbing in symbrachydactyly may result from failure of the apical ectodermal ridge under the influence of damaged mesenchyme.

Occupational acroosteolysis in a guitar player.

PubMed

Baran, R; Tosti, A

1993-02-01

A case of occupational acroosteolysis in a 24-year-old classical guitar player is reported. Nail tenderness was the only manifestation of initial acroosteolysis, which was due to mechanical stress on the fingers. Radiographs showed initial resorption of the 2nd, 3rd and 4th finger of the left hand. The authors review the clinical and radiological features of acroosteolysis. The pathogenesis of acroosteolysis is discussed as well as the different diseases that may cause destructive changes of the distal phalangeal bones.

"Palmar pivot flap" for resurfacing palmar lateral defects of the fingers.

PubMed

Yam, Andrew; Peng, Yeong-Pin; Pho, Robert Wan-Heng

2008-12-01

Soft tissue defects on the lateral borders of the digits are difficult to reconstruct using local or local-regional flaps. We describe a "palmar pivot flap" to resurface an adjacent defect on the palmar-lateral aspect of the digit. The surgical technique is described. This flap is an axial pattern flap based on the subcutaneous transverse branches of the digital artery. The flap is pivoted up to 90 degrees on the neurovascular bundle in its base, into an adjacent defect. The flap can be raised from either the proximal or the middle phalangeal segments. It can cover defects sited from the level of the proximal interphalangeal joint up to the fingertip. The donor defect is limited to the same digit and is covered with a full-thickness skin graft. We have used this flap on 3 patients with defects at the middle phalangeal segment, the distal interphalangeal joint, and the fingertip. All healed primarily. One patient had a mild flexion contracture of the proximal interphalangeal joint, whereas the other 2 had no complications. The patients with distal interphalangeal joint and fingertip defects had excellent sensation in the flap (2-point discrimination of 5-6 mm). The palmar pivot flap is useful for resurfacing otherwise difficult defects on the lateral borders of the digits around and distal to the proximal interphalangeal joint, including those at the fingertip. It provides sensate, glabrous skin. The donor defect is on the same digit and is well hidden, producing an aesthetic and functional reconstruction.

Melorheostosis in the upper extremity.

PubMed

Yildirim, Cengiz; Ozyürek, Selahattin; Ciçek, Engin Ilker; Kuskucu, Mesih

2009-04-01

Melorheostosis is a rare mesodermal disease affecting the skeleton and adjacent soft tissues. Often it is incidentally detected on radiographs. In the standard radiology and orthopedics literature, melorheostosis is described as a "flowing hyperostosis, resembling dripping candle wax as an incidental radiographic finding." A 22-year-old man presented with a 2-year history of right-hand pain. Radiologic evaluation of the hand showed massive sclerotic changes in the first and second metacarpal and phalangeal bones on the right side. Further radiographic evaluation of the right upper extremity revealed the same sclerotic changes in the right scapula, humerus, radius, and scaphoid. Computed tomography (CT) scans showed a high attenuation undulating cortical hyperostosis with a "dripping candle wax appearance" involving the radial and/or dorsal aspects of humerus, radius, scaphoid, and first and second ray bones of the hand. Radionuclide triphasic bone scintigraphy showed diffuse homogenous radiotracer uptake within the entire right upper extremity involving the scapula, humerus, radius, scaphoid, and first and second metacarpals and phalangeal bones of the hand. The patient was followed conservatively, and 1-year follow-up revealed no change in the clinical, laboratory, or radiological findings. The diagnosis of melorheostosis was made on the basis of the characteristic distribution, location, and combined radiographic, CT, and radionuclide imaging features of the abnormalities. Conservative treatment was recommended for the patient. After 26 months of follow-up, despite the persistence of the radiologic findings, the patient is currently well, with no painful symptoms unless he performs forceful exercise.

How Hinge Positioning in Cross-Country Ski Bindings Affect Exercise Efficiency, Cycle Characteristics and Muscle Coordination during Submaximal Roller Skiing

PubMed Central

Bolger, Conor M.; Sandbakk, Øyvind; Ettema, Gertjan; Federolf, Peter

2016-01-01

The purposes of the current study were to 1) test if the hinge position in the binding of skating skis has an effect on gross efficiency or cycle characteristics and 2) investigate whether hinge positioning affects synergistic components of the muscle activation in six lower leg muscles. Eleven male skiers performed three 4-min sessions at moderate intensity while cross-country ski-skating and using a klapskate binding. Three different positions were tested for the binding’s hinge, ranging from the front of the first distal phalange to the metatarsal-phalangeal joint. Gross efficiency and cycle characteristics were determined, and the electromyographic (EMG) signals of six lower limb muscles were collected. EMG signals were wavelet transformed, normalized, joined into a multi-dimensional vector, and submitted to a principle component analysis (PCA). Our results did not reveal any changes to gross efficiency or cycle characteristics when altering the hinge position. However, our EMG analysis found small but significant effects of hinge positioning on muscle coordinative patterns (P < 0.05). The changed patterns in muscle activation are in alignment with previously described mechanisms that explain the effects of hinge positioning in speed-skating klapskates. Finally, the within-subject results of the EMG analysis suggested that in addition to the between-subject effects, further forms of muscle coordination patterns appear to be employed by some, but not all participants. PMID:27203597

Motion representation of the long fingers: a proposal for the definitions of new anatomical frames.

PubMed

Coupier, Jérôme; Moiseev, Fédor; Feipel, Véronique; Rooze, Marcel; Van Sint Jan, Serge

2014-04-11

Despite the availability of the International Society of Biomechanics (ISB) recommendations for the orientation of anatomical frames, no consensus exists about motion representations related to finger kinematics. This paper proposes novel anatomical frames for motion representation of the phalangeal segments of the long fingers. A three-dimensional model of a human forefinger was acquired from a non-pathological fresh-frozen hand. Medical imaging was used to collect phalangeal discrete positions. Data processing was performed using a customized software interface ("lhpFusionBox") to create a specimen-specific model and to reconstruct the discrete motion path. Five examiners virtually palpated two sets of landmarks. These markers were then used to build anatomical frames following two methods: a reference method following ISB recommendations and a newly-developed method based on the mean helical axis (HA). Motion representations were obtained and compared between examiners. Virtual palpation precision was around 1mm, which is comparable to results from the literature. The comparison of the two methods showed that the helical axis method seemed more reproducible between examiners especially for secondary, or accessory, motions. Computed Root Mean Square distances comparing methods showed that the ISB method displayed a variability 10 times higher than the HA method. The HA method seems to be suitable for finger motion representation using discrete positions from medical imaging. Further investigations are required before being able to use the methodology with continuous tracking of markers set on the subject's hand. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Oldest Case of Decapitation in the New World (Lapa do Santo, East-Central Brazil).

PubMed

Strauss, André; Oliveira, Rodrigo Elias; Bernardo, Danilo V; Salazar-García, Domingo C; Talamo, Sahra; Jaouen, Klervia; Hubbe, Mark; Black, Sue; Wilkinson, Caroline; Richards, Michael Phillip; Araujo, Astolfo G M; Kipnis, Renato; Neves, Walter Alves

2015-01-01

We present here evidence for an early Holocene case of decapitation in the New World (Burial 26), found in the rock shelter of Lapa do Santo in 2007. Lapa do Santo is an archaeological site located in the Lagoa Santa karst in east-central Brazil with evidence of human occupation dating as far back as 11.7-12.7 cal kyBP (95.4% interval). An ultra-filtered AMS age determination on a fragment of the sphenoid provided an age range of 9.1-9.4 cal kyBP (95.4% interval) for Burial 26. The interment was composed of an articulated cranium, mandible and first six cervical vertebrae. Cut marks with a v-shaped profile were observed in the mandible and sixth cervical vertebra. The right hand was amputated and laid over the left side of the face with distal phalanges pointing to the chin and the left hand was amputated and laid over the right side of the face with distal phalanges pointing to the forehead. Strontium analysis comparing Burial 26's isotopic signature to other specimens from Lapa do Santo suggests this was a local member of the group. Therefore, we suggest a ritualized decapitation instead of trophy-taking, testifying for the sophistication of mortuary rituals among hunter-gatherers in the Americas during the early Archaic period. In the apparent absence of wealth goods or elaborated architecture, Lapa do Santo's inhabitants seemed to use the human body to express their cosmological principles regarding death.

Racing performance of Swedish Standardbred trotting horses with proximal palmar/plantar first phalangeal (Birkeland) fragments compared to fragment free controls.

PubMed

Carmalt, James L; Borg, Hanna; Näslund, Hans; Waldner, Cheryl

2014-10-01

The aim of this study was to determine whether horses with a proximal palmar/plantar first phalangeal osteochondral fragment (POF) had comparable racing careers (prior to and following surgery) to horses without this fracture. A retrospective cohort study included 174 Swedish Standardbred trotters with osteochondral fragmentation in the palmar/plantar fetlock joint and 613 radiographically negative control horses presented for prepurchase examinations. Medical records and radiographs were examined for each horse. Racing data were retrieved from online Swedish Standardbred harness racing records. The effect of having a POF on race speed compared to radiographically negative control horses was examined using generalised estimating equations. Multivariable regression was used to examine differences in money earned and career longevity. The horses raced a total of 16,448 races. Horses gained speed as a function of race number. There was no difference in racing speed between horses with POF fractures that raced before surgery and control horses. Horses did not slow before, nor speed up after, surgery. There was no difference in the number of days between the last race prior to, or the first race after, the hospital visit between POF and control horses. Career earnings and lifetime starts were not significantly different between groups. The results of this study suggest the need to reevaluate the previously reported benefits of surgical intervention for POF. Copyright © 2014 Elsevier Ltd. All rights reserved.

Comparative morphology of the pollical distal phalanx.

PubMed

Shrewsbury, M M; Marzke, M W; Linscheid, R L; Reece, S P

2003-05-01

Functional analysis of human pollical distal phalangeal (PDP) morphology is undertaken to establish a basis for the assessment of fossil hominid PDP morphology. Features that contribute to the effectiveness of grips involving the distal thumb and finger pulp areas include: 1) distal thumb interphalangeal joint morphology, facilitating PDP conjunct pronation with flexion; 2) differentiation of a proximal, mobile pulp region from a distal, stable pulp region, providing for firm precision pinch grips and precision handling of objects; and 3) asymmetric attachment of the flexor pollicis longus (FPL) tendon fibers, favoring PDP conjunct pronation. A proportionately larger size of the ulnar vs. radial ungual spine suggests differential loading intensity of the ulnar side of the proximal ungual pulp and supporting nail bed. Stresses at the distal interphalangeal joint are indicated by the presence of a sesamoid bone within the volar (palmar) plate, which also increases the length of the flexor pollicis longus tendon moment arm. Dissections of specimens from six nonhuman primate genera indicate that these human features are shared variably with individuals in other species, although the full pattern of features appears to be distinctively human. Humans share variably with these other species all metric relationships examined here. The new data identify a need to systematically review long-standing assumptions regarding the range of precision and power manipulative capabilities that might reasonably be inferred from morphology of the distal phalangeal tuberosity and from the FPL tendon insertion site on the PDP. Copyright 2003 Wiley-Liss, Inc.

Use of quantitative ultrasound of the hand phalanges in the diagnosis of two different osteoporotic syndromes: Cushing's syndrome and postmenopausal osteoporosis.

PubMed

Camozzi, V; Carraro, V; Zangari, M; Fallo, F; Mantero, F; Luisetto, G

2004-06-01

The aim of this study was to assess the ability of the quantitative ultrasound of the hand phalanges to detect different types of osteoporosis resulting from different pathogenetic mechanisms. For this purpose, postmenopausal and glucocorticoid-induced osteoporosis was studied. Thirteen female patients with Cushing's syndrome (CS) resulting from pituitary-dependent bilateral adrenal hyperplasia (10 patients) and from adrenal adenoma (3 patients), and 32 postmenopausal osteoporotic (OP) women, were examined. The two groups of patients were comparable for body mass index (BMI), but CS patients were significantly younger than OP ones (CS 44.5+/-11.6; OP: 73.9+/-3.6). All the patients had femoral neck bone mineral density (BMD) T-score less than -2.0. Cushing patients had a femoral neck BMD similar to that of OP patients (CS: 603+/-66 mg/cm2; OP: 628+/-69 mg/cm2; p=0.19). In contrast, amplitude-dependent speed of sound (AD-SoS) was significantly higher in CS patients than in OP patients (CS: 1997+/-91 m/s; OP: 1707+/-114 m/s; p<0.0001). By adjusting DXA and ultrasound parameters according to age, femoral neck BMD was significantly lower in CS patients and AD-SoS remained significantly higher than in OP patients. These findings indicate that these two different kinds of osteoporosis can be distinguished by ultrasonography and that ultrasound parameters alone cannot be used for evaluating skeletal status in CS patients.

Description of a new species of Microhyla from Bali, Indonesia (Amphibia, Anura).

PubMed

Matsui, Masafumi; Hamidy, Amir; Eto, Koshiro

2013-01-01

We describe a microhylid frog from Bali, Indonesia as a new species, Microhyla orientalis sp. nov. It belongs to the M. achatina group and is close to M. mantheyi, M. malang, and M. borneensis. It is distinguished from its congeners by a combination of the following characters: small size (adult males about 16-17 mm in SVL); a faint vertebral stripe present; a black lateral stripe from behind eye to half length of trunk; snout rounded in profile; eyelid without supraciliary spines; first finger less than one-fifth of third; tips of three outer fingers weakly dilated, forming weak disks, dorsally with median longitudinal groove; outer palmar tubercle single; tibiotarsal articulation reaching up to center of eye; tips of toes distinctly dilated into disks, dorsally with median longitudinal groove; inner and outer metatarsal tubercles present; four or more phalanges on inner and outer sides of fourth toe, and three phalanges on inner side of fifth toe free of web; and tail of larva with a black marking at middle. The male advertisement call of the new species consists of a series of notes each lasts for 0.01-0.08 s and composed of 3-5 pulses with a dominant frequency of 3.2-3.6 kHz. Uncorrected sequence divergences between M. orientalis and all homologous 16S rRNA sequences available were > 6.6%. At present, the new species is known from rice fields between 435-815 m elevation in Wongaya Gede and Batukaru.

BONE MASS BY QUANTITATIVE ULTRASOUND OF FINGER PHALANGES IN YOUNG KARATE PRACTITIONERS

PubMed Central

Barbeta, Camila Justino de Oliveira; Gonçalves, Ezequiel Moreira; Ribeiro, Keila Donassolo Santos; Ribeiro, Roberto; Roman, Everton Paulo; Guerra-Júnior, Gil

2017-01-01

ABSTRACT Objective: To evaluate bone mass by quantitative ultrasound of the phalanges in young karate practitioners compared to a control group. Methods: Sample composed of 162 karate practitioners (52 females) and 326 healthy controls (110 females) aged 6 to 16 years old, in Western Paraná (Southern Brazil). Weight, height, BMI, amplitude-dependent speed of sound (AD-SoS) and bone transmission time (BTT) were evaluated. BMI, AD-SoS and BTT values were converted to Z scores. Mann-Whitney, chi-square or Fisher Exact tests and multiple linear regression were applied, with significance level set at p≤0.05. Results: Both genders showed higher values of BTT as Z scores when compared to control group. Females from the control group had higher AD-SoS values (m/s and Z score) compared to female karate practitioners. When relative and absolute frequencies were assessed according to BTT Z score in both groups, male karate practitioners’ bone mass was shown to be adequate more frequently. In female practitioners, age and weight were independent predictors of AD-SoS (R2=0.42) and BTT (R2=0.45), respectively. Among male karate practitioners, age was related to 26% of AD-SoS variances and height was responsible for 36% of BTT variances. Conclusions: Children and adolescents who practice karate were shown to have more bone mass in comparison to the control group, regardless of gender. BTT was more sensitive for this evaluation. PMID:28977128

Hand kinematics of piano playing

PubMed Central

Flanders, Martha; Soechting, John F.

2011-01-01

Dexterous use of the hand represents a sophisticated sensorimotor function. In behaviors such as playing the piano, it can involve strong temporal and spatial constraints. The purpose of this study was to determine fundamental patterns of covariation of motion across joints and digits of the human hand. Joint motion was recorded while 5 expert pianists played 30 excerpts from musical pieces, which featured ∼50 different tone sequences and fingering. Principal component analysis and cluster analysis using an expectation-maximization algorithm revealed that joint velocities could be categorized into several patterns, which help to simplify the description of the movements of the multiple degrees of freedom of the hand. For the thumb keystroke, two distinct patterns of joint movement covariation emerged and they depended on the spatiotemporal patterns of the task. For example, the thumb-under maneuver was clearly separated into two clusters based on the direction of hand translation along the keyboard. While the pattern of the thumb joint velocities differed between these clusters, the motions at the metacarpo-phalangeal and proximal-phalangeal joints of the four fingers were more consistent. For a keystroke executed with one of the fingers, there were three distinct patterns of joint rotations, across which motion at the striking finger was fairly consistent, but motion of the other fingers was more variable. Furthermore, the amount of movement spillover of the striking finger to the adjacent fingers was small irrespective of the finger used for the keystroke. These findings describe an unparalleled amount of independent motion of the fingers. PMID:21880938

Robonaut 2 (R2) Overview

NASA Technical Reports Server (NTRS)

Diftler, Myron

2010-01-01

This slide presentation reviews the development and uses of the second robot designed to work in space. The presentation reviews the motivation for developing Robonaut, the cooperative commercial relationship with General Motors, the evolution design of Robonaut Robonaut 2 improvements over the first robonaut (R1), Robonaut 2's hand dexterity, finger impedance control, tactile system, finger haptics, arm control, strength, neck movement and head sensors, human interaction, and the controller. Also the plans for use on board the International Space Station are reviewed. The patent for the Phalange Tactile Load Cell is included.

Dorsal dimelia in patau syndrome: a case report.

PubMed

Fattah, A; Pickford, M A

2007-10-01

We present a case of a child with Patau syndrome that exhibits features consistent with congenital palmar nail syndrome. The literature is reviewed and evidence presented to demonstrate that this is a defect in the dorso-ventral patterning of the limb and thus a form of dorsal dimelia. In order to differentiate this from other instances of ectopic nail tissue we suggest congenital palmar nail syndrome should be more specifically defined as duplicated nails, absent flexion creases, non-glabrous skin on the palmar surface, reduced movement at the interphalangeal joints and hypoplastic terminal phalanges.

Immediate effects of an artificial change in hoof angulation on the dorsal metacarpophalangeal joint angle and cross-sectional areas of both flexor tendons.

PubMed

Hagen, Jenny; Kojah, Kaid; Geiger, Michael; Vogel, Mandy

2018-06-16

Corrective shoeing is used to change hoof angulation with the intention to influence the angulation of the digital joints to reduce strain on associated tendons. The objective of this study is to examine how gradual changes in hoof angulation affect the dorsal metacarpophalangeal joint (DMPJ) angulation and cross-sectional areas (CSAs) of the deep digital flexor tendon (DDFT) and superficial digital flexor tendon (SDFT) concerning the individual toe conformation. Forelimbs of 30 horses were examined barefoot and equipped with 5°, 10° and 20° toe wedges (TWs) and heel wedges (HWs). Phalangeal angulation and lengths were measured in lateromedial radiographs of the digit. CSAs of both flexor tendons was calculated in sonographic images. Significant effects on the DMPJ and CSA of the DDFT/SDFT were measured with 10° and 20° HWs or 20° TWs. Both flexor tendons showed increasing CSA after heel elevation. Significant interindividual variations occurred. Phalangeal angulation and length influenced the responsivity of the parameters to a changed hoof angulation. Significant impact of corrective shoeing on the DMPJ and flexor tendons is related to a distinct change in hoof orientation and varies with individual toe conformation. Similar response of the DDFT and SDFT to raised and lowered hoof orientation needs further investigation for a more specific application of therapeutic shoeing. © British Veterinary Association (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Thricho-rhino-phalangeal syndrome and severe osteoporosis: a rare association or a feature? An effective therapeutic approach with biphosphonates.

PubMed

Macchiaiolo, M; Mennini, M; Digilio, M C; Buonuomo, P S; Lepri, F R; Gnazzo, M; Grandin, A; Angioni, A; Bartuli, A

2014-03-01

Trichorhinophalangeal syndrome (TRPS) is a rare, autosomal dominant malformation syndrome characterized by hair, craniofacial and skeletal abnormalities, skin laxity, deformation of phalanges and anomalies of pelvis, femurs, and tibias. Three subtypes have been described: TRPS I, caused by mutations in TRPS1 gene on chromosome 8; TRPS II, a microdeletion syndrome affecting the TRPS1 and EXT1 genes; and TRPS III, a form with severe brachydactyly, due to short metacarpals, and severe short stature, but without exostoses. We present the case of a 7-year-old boy, affected by TRPS with a severe osteoporosis and several spontaneous bone fractures, an association described only once in the literature, successfully treated with biphosphonates. Bone mineral density (BMD) at dual-energy X-ray Absorptiometry (DXA) was of 0.331 g/cm(2) at lumbar spine with. He had four spontaneous femoral fractures in a year, and for this reason he was been operated for positioning intramedullary osteosynthesis and orthopedic supports. Due to the severity of the clinical and radiological pattern it was established, after approval of the Ethical Committee, to begin off-label therapy with infusions of neridronate at a dose of 2 mg/kg IV every 3 months. The treatment was, in this patient, effective both in terms of clinical (absence of new fractures) and mineralomethric (+45% BMD ath the lumbar level). We therefore suggest that treatment with biphosponates can be taken in account as a possible therapeutic option in case of bone fragility in patients with TRPSI. © 2013 Wiley Periodicals, Inc.

Computed tomographic anatomy of the equine foot.

PubMed

Claerhoudt, S; Bergman, E H J; Saunders, J H

2014-10-01

This study describes a detailed computed tomographic reference of the normal equine foot. Ten forefeet of five adult cadavers, without evidence of orthopaedic disease, were used. Computed tomography (CT) was performed on all feet. Two-millimetre thick transverse slices were obtained, and sagittal and dorsal planes were reformatted. The CT images were matched with the corresponding anatomic slices. The phalanges and the distal sesamoid bone showed excellent detail. The extensor and flexor tendons (including their attachments) could be clearly evaluated. The collateral (sesamoidean) ligaments could be readily located, but were difficult to delineate at their proximal attachment. The distal digital annular ligament could only be distinguished from the deep digital flexor tendon proximal to the distal sesamoid bone, and its proximal attachment could be identified, but not its distal insertion. Small ligaments (impar ligament, chondrosesamoidean, chondrocoronal and chondrocompedal ligaments, axial and abaxial palmar ligaments of the proximal inter-phalangeal joint) were seen with difficulty and not at all slices. The joint capsules could not be delineated from the surrounding soft tissue structures. The lateral and medial proprius palmar digital artery and vein could be visualized occasionally on some slices. The ungular cartilages, corium and hoof wall layering were seen. The nerves, the articular and fibrocartilage of the distal sesamoid bone and the chondroungular ligament could not be assessed. Computed tomography of the equine foot can be of great value when results of radiography and ultrasonography are inconclusive. Images obtained in this study may serve as reference for CT of the equine foot. © 2013 Blackwell Verlag GmbH.

The Oldest Case of Decapitation in the New World (Lapa do Santo, East-Central Brazil)

PubMed Central

Strauss, André; Oliveira, Rodrigo Elias; Bernardo, Danilo V.; Salazar-García, Domingo C.; Talamo, Sahra; Jaouen, Klervia; Hubbe, Mark; Black, Sue; Wilkinson, Caroline; Richards, Michael Phillip; Araujo, Astolfo G. M.; Kipnis, Renato; Neves, Walter Alves

2015-01-01

We present here evidence for an early Holocene case of decapitation in the New World (Burial 26), found in the rock shelter of Lapa do Santo in 2007. Lapa do Santo is an archaeological site located in the Lagoa Santa karst in east-central Brazil with evidence of human occupation dating as far back as 11.7–12.7 cal kyBP (95.4% interval). An ultra-filtered AMS age determination on a fragment of the sphenoid provided an age range of 9.1–9.4 cal kyBP (95.4% interval) for Burial 26. The interment was composed of an articulated cranium, mandible and first six cervical vertebrae. Cut marks with a v-shaped profile were observed in the mandible and sixth cervical vertebra. The right hand was amputated and laid over the left side of the face with distal phalanges pointing to the chin and the left hand was amputated and laid over the right side of the face with distal phalanges pointing to the forehead. Strontium analysis comparing Burial 26’s isotopic signature to other specimens from Lapa do Santo suggests this was a local member of the group. Therefore, we suggest a ritualized decapitation instead of trophy-taking, testifying for the sophistication of mortuary rituals among hunter-gatherers in the Americas during the early Archaic period. In the apparent absence of wealth goods or elaborated architecture, Lapa do Santo’s inhabitants seemed to use the human body to express their cosmological principles regarding death. PMID:26397983

Skeletal pathology and variable anatomy in elephant feet assessed using computed tomography

PubMed Central

Dixon, Jonathon J.I.; Warren-Smith, Chris; Hutchinson, John R.; Weller, Renate

2017-01-01

Foot problems are a major cause of morbidity and mortality in elephants, but are underreported due to difficulties in diagnosis, particularly of conditions affecting the bones and internal structures. Here we evaluate post-mortem computer tomographic (CT) scans of 52 feet from 21 elephants (seven African Loxodonta africana and 14 Asian Elephas maximus), describing both pathology and variant anatomy (including the appearance of phalangeal and sesamoid bones) that could be mistaken for disease. We found all the elephants in our study to have pathology of some type in at least one foot. The most common pathological changes observed were bone remodelling, enthesopathy, osseous cyst-like lesions, and osteoarthritis, with soft tissue mineralisation, osteitis, infectious osteoarthriti, subluxation, fracture and enostoses observed less frequently. Most feet had multiple categories of pathological change (81% with two or more diagnoses, versus 10% with a single diagnosis, and 9% without significant pathology). Much of the pathological change was focused over the middle/lateral digits, which bear most weight and experience high peak pressures during walking. We found remodelling and osteoarthritis to be correlated with increasing age, more enthesopathy in Asian elephants, and more cyst-like lesions in females. We also observed multipartite, missing and misshapen phalanges as common and apparently incidental findings. The proximal (paired) sesamoids can appear fused or absent, and the predigits (radial/tibial sesamoids) can be variably ossified, though are significantly more ossified in Asian elephants. Our study reinforces the need for regular examination and radiography of elephant feet to monitor for pathology and as a tool for improving welfare. PMID:28123909

Age-Related Differences in Collagen-Induced Arthritis: Clinical and Imaging Correlations

PubMed Central

Wilson-Gerwing, Tracy D; Pratt, Isaac V; Cooper, David M L; Silver, Tawni I; Rosenberg, Alan M

2013-01-01

Arthritis is among the most common chronic diseases in both children and adults. Although intraarticular inflammation is the feature common among all patients with chronic arthritis there are, in addition to age at onset, clinical characteristics that further distinguish the disease in pediatric and adult populations. In this study, we aimed to demonstrate the utility of microCT (µCT) and ultrasonography in characterizing pathologic age-related differences in a collagen-induced arthritis (CIA) rat model. Juvenile (35 d old) and young adult (91 d old) male Wistar rats were immunized with bovine type II collagen and incomplete Freund adjuvant to induce polyarthritis. Naïve male Wistar rats served as controls. All paws were scored on a scale of 0 (normal paw) to 4 (disuse of paw). Rats were euthanized at 14 d after the onset of arthritis and the hindpaws imaged by µCT and ultrasonography. Young adult rats had more severe signs of arthritis than did their juvenile counterparts. Imaging demonstrated that young adult CIA rats exhibited more widespread and severe skeletal lesions of the phalanges, metatarsals, and tarsal bones, whereas juvenile CIA rats had more localized and less proliferative and osteolytic damage that was confined predominantly to the phalanges and metatarsals. This report demonstrates the utility of imaging modalities to compare juvenile and young adult rats with CIA and provides evidence that disease characteristics and progression differ between the 2 age groups. Our observations indicate that the CIA model could help discern age-related pathologic processes in inflammatory joint diseases. PMID:24326225

Evaluation of handle design characteristics in a maximum screwdriving torque task.

PubMed

Kong, Y-K; Lowe, B D; Lee, S-J; Krieg, E F

2007-09-01

The purpose of this study was to evaluate the effects of screwdriver handle shape, surface material and workpiece orientation on torque performance, finger force distribution and muscle activity in a maximum screwdriving torque task. Twelve male subjects performed maximum screw-tightening exertions using screwdriver handles with three longitudinal shapes (circular, hexagonal and triangular), four lateral shapes (cylindrical, double frustum, cone and reversed double frustum) and two surfaces (rubber and plastic). The average finger force contributions to the total hand force were 28.1%, 39.3%, 26.5% and 6.2%, in order from index to little fingers; the average phalangeal segment force contributions were 47.3%, 14.0%, 20.5% and 18.1% for distal, middle, proximal and metacarpal phalanges, respectively. The plastic surface handles were associated with 15% less torque output (4.86 Nm) than the rubber coated handles (5.73 Nm). In general, the vertical workpiece orientation was associated with higher torque output (5.9 Nm) than the horizontal orientation (4.69 Nm). Analysis of handle shapes indicates that screwdrivers designed with a circular or hexagonal cross-sectional shape result in greater torque outputs (5.49 Nm, 5.57 Nm), with less total finger force (95 N, 105 N). In terms of lateral shape, reversed double frustum handles were associated with less torque output (5.23 Nm) than the double frustum (5.44 Nm) and cone (5.37 Nm) handles. Screwdriver handles designed with combinations of circular or hexagonal cross-sectional shapes with double frustum and cone lateral shapes were optimal in this study.

Prevalence of abnormal radiographic findings in 2-year-old Thoroughbreds at in-training sales and associations with racing performance.

PubMed

Meagher, Dennis M; Bromberek, Julia L; Meagher, Daniel T; Gardner, Ian A; Puchalski, Sarah M; Stover, Susan M

2013-04-01

To estimate the prevalence of radiographic abnormalities (lesions) in Thoroughbred racehorses at 2-year-old in-training sales and determine whether these lesions and 1-furlong presale workout times were associated with subsequent racing performance. Retrospective cohort study. 953 Thoroughbreds. Repository radiographs of carpal, metacarpophalangeal and metatarsophalangeal (fetlock), stifle, and tarsal (hock) joints were examined. Horses with lesions were classified by lesion type and location. Race performance variables were compared between horses with and without lesions and between horses categorized by 1-furlong presale workout times (< or ≥ 11 seconds). 299 horses had ≥ 1 lesion, and 654 had no lesion detected. Odds of starting a race and of earning money racing were lower for horses with any lesion and lower for horses with proximal phalangeal dorsoproximal articular margin chip fracture, proximal sesamoid bone fracture or sesamoiditis, or wedge-shaped central or third tarsal bones, compared with horses that had no lesion. For horses that raced, proximal phalangeal dorsoproximal articular margin chip fractures were associated with lower lifetime earnings, and flattening of the medial femoral condyle was associated with fewer 3-year-old racing starts, compared with values for horses that had no lesion. Horses with workout times < 11 seconds had greater odds of having lifetime starts, lifetime earnings, and maximum purse above threshold (median) values than did horses with slower workout times. No radiographic lesions prevented all affected horses from racing. Among horses that raced, few differences were found in performance for horses with and without lesions.

Robotic Thumb Assembly

NASA Technical Reports Server (NTRS)

Ihrke, Chris A. (Inventor); Bridgwater, Lyndon (Inventor); Platt, Robert (Inventor); Wampler, II, Charles W. (Inventor); Goza, S. Michael (Inventor)

2013-01-01

An improved robotic thumb for a robotic hand assembly is provided. According to one aspect of the disclosure, improved tendon routing in the robotic thumb provides control of four degrees of freedom with only five tendons. According to another aspect of the disclosure, one of the five degrees of freedom of a human thumb is replaced in the robotic thumb with a permanent twist in the shape of a phalange. According to yet another aspect of the disclosure, a position sensor includes a magnet having two portions shaped as circle segments with different center points. The magnet provides a linearized output from a Hall effect sensor.

Intramedullary Percutaneous Fixation of Extra-Articular Proximal and Middle Phalanx Fractures.

PubMed

Jovanovic, Nebojsa; Aldlyami, Ehab; Saraj, Basem; Fm Seidam, Mohamed; Badawi, Hamed; Shaat, Ahmed; Alawadi, Khalid; Dodakundi, Chaitanya

2018-06-01

Multiple methods have been described for treating unstable proximal and middle phalangeal fractures. Irrespective of using an open or closed technique of fixation, stiffness and extensor lag at the proximal/distal interphalangeal joint almost always occur. This issue can be avoided by allowing the patients to mobilize the fingers out of plaster or splint as early as possible from the day of surgery. We describe a technique of intramedullary percutaneous fixation of extra-articular proximal and middle phalanx fractures allowing immediate mobilization of fingers, concurrent stabilization with progressive healing and thus preventing such complications.

Clinical study of symbrachydactyly of the foot.

PubMed

Uchida, T; Kojima, T; Hirakawa, M

1995-07-01

Seventeen patients with symbrachydactyly of the foot are described. Patient characteristics including sex, the side of the affected foot, age at first medical examination, and condition of the nails were recorded. Compared with the unaffected side, the lengths of the proximal phalangeal and metatarsal bones were significantly shorter. The abnormalities of the feet were classified into four types: typical axial, atypical axial, medial ray, and rudimentary. The anomaly progresses from hypoplasia of the central rays to a deformity of the great toe, but rarely involves the fifth toe. The fact that this differs from symbrachydactyly of the hand is of considerable interest.

Megalosauripus transjuranicus ichnosp. nov. A new Late Jurassic theropod ichnotaxon from NW Switzerland and implications for tridactyl dinosaur ichnology and ichnotaxomy

PubMed Central

Razzolini, Novella L.; Belvedere, Matteo; Marty, Daniel; Paratte, Géraldine; Lovis, Christel; Cattin, Marielle; Meyer, Christian A.

2017-01-01

A new ichnospecies of a large theropod dinosaur, Megalosauripus transjuranicus, is described from the Reuchenette Formation (Early–Late Kimmeridgian, Late Jurassic) of NW Switzerland. It is based on very well-preserved and morphologically-distinct tracks (impressions) and several trackways, including different preservational types from different tracksites and horizons. All trackways were excavated along federal Highway A16 near Courtedoux (Canton Jura) and systematically documented in the field including orthophotos and laserscans. The best-preserved tracks were recovered and additional tracks were casted. Megalosauripus transjuranicus is characterized by tridactyl tracks with clear claw and digital pad impressions, and notably an exceptionally large and round first phalangeal pad on the fourth digit (PIV1) that is connected to digit IV and forms the round heel area. Due to this combination of features, M. transjuranicus clearly is of theropod (and not ornithopod) origin. M. transjuranicus is compared to other Megalosauripus tracks and similar ichnotaxa and other unassigned tracks from the Early Jurassic to Early Cretaceous. It is clearly different from other ichnogenera assigned to large theropods such as Eubrontes–Grallator from the Late Triassic and Early Jurassic or Megalosauripus–Megalosauropus–Bueckeburgichnus and Therangospodus tracks from the Late Jurassic and Early Cretaceous. A second tridactyl morphotype (called Morphotype II) is different from Megalosauripus transjuranicus in being subsymmetric, longer than wide (sometimes almost as wide as long), with blunt toe impressions and no evidence for discrete phalangeal pad and claw marks. Some Morphotype II tracks are found in trackways that are assigned to M. transjuranicus, to M.? transjuranicus or M. cf. transjuranicus indicating that some Morphotype II tracks are intra-trackway preservational variants of a morphological continuum of Megalosauripus transjuranicus. On the other hand, several up to 40 steps long trackways very consistently present Morphotype II features (notably blunt digits) and do not exhibit any of the features that are typical for Megalosauripus (notably phalangeal pads). Therefore, it is not very likely that these tracks are preservational variants of Megalosauripus transjuranicus or Megalosauripus isp. These trackways are interpreted to have been left by an ornithopod dinosaur. The high frequency of large theropod tracks in tidal-flat deposits of the Jura carbonate platform, associated on single ichnoassemblages with minute to medium-sized tridactyl and tiny to large sauropod tracks has important implications for the dinosaur community and for paleoenvironmental and paleogeographical reconstructions. As with most other known occurrences of Megalosauripus tracks, M. transjuranicus is found in coastal settings, which may reflect the preference of their theropod trackmakers for expanded carbonate flats where food was abundant. PMID:28715504

Megalosauripus transjuranicus ichnosp. nov. A new Late Jurassic theropod ichnotaxon from NW Switzerland and implications for tridactyl dinosaur ichnology and ichnotaxomy.

PubMed

Razzolini, Novella L; Belvedere, Matteo; Marty, Daniel; Paratte, Géraldine; Lovis, Christel; Cattin, Marielle; Meyer, Christian A

2017-01-01

A new ichnospecies of a large theropod dinosaur, Megalosauripus transjuranicus, is described from the Reuchenette Formation (Early-Late Kimmeridgian, Late Jurassic) of NW Switzerland. It is based on very well-preserved and morphologically-distinct tracks (impressions) and several trackways, including different preservational types from different tracksites and horizons. All trackways were excavated along federal Highway A16 near Courtedoux (Canton Jura) and systematically documented in the field including orthophotos and laserscans. The best-preserved tracks were recovered and additional tracks were casted. Megalosauripus transjuranicus is characterized by tridactyl tracks with clear claw and digital pad impressions, and notably an exceptionally large and round first phalangeal pad on the fourth digit (PIV1) that is connected to digit IV and forms the round heel area. Due to this combination of features, M. transjuranicus clearly is of theropod (and not ornithopod) origin. M. transjuranicus is compared to other Megalosauripus tracks and similar ichnotaxa and other unassigned tracks from the Early Jurassic to Early Cretaceous. It is clearly different from other ichnogenera assigned to large theropods such as Eubrontes-Grallator from the Late Triassic and Early Jurassic or Megalosauripus-Megalosauropus-Bueckeburgichnus and Therangospodus tracks from the Late Jurassic and Early Cretaceous. A second tridactyl morphotype (called Morphotype II) is different from Megalosauripus transjuranicus in being subsymmetric, longer than wide (sometimes almost as wide as long), with blunt toe impressions and no evidence for discrete phalangeal pad and claw marks. Some Morphotype II tracks are found in trackways that are assigned to M. transjuranicus, to M.? transjuranicus or M. cf. transjuranicus indicating that some Morphotype II tracks are intra-trackway preservational variants of a morphological continuum of Megalosauripus transjuranicus. On the other hand, several up to 40 steps long trackways very consistently present Morphotype II features (notably blunt digits) and do not exhibit any of the features that are typical for Megalosauripus (notably phalangeal pads). Therefore, it is not very likely that these tracks are preservational variants of Megalosauripus transjuranicus or Megalosauripus isp. These trackways are interpreted to have been left by an ornithopod dinosaur. The high frequency of large theropod tracks in tidal-flat deposits of the Jura carbonate platform, associated on single ichnoassemblages with minute to medium-sized tridactyl and tiny to large sauropod tracks has important implications for the dinosaur community and for paleoenvironmental and paleogeographical reconstructions. As with most other known occurrences of Megalosauripus tracks, M. transjuranicus is found in coastal settings, which may reflect the preference of their theropod trackmakers for expanded carbonate flats where food was abundant.

Real time relationship between individual finger force and grip exertion on distal phalanges in linear force following tasks.

PubMed

Luo, Shi-Jian; Shu, Ge; Gong, Yan

2018-05-01

Individual finger force (FF) in a grip task is a vital concern in rehabilitation engineering and precise control of manipulators because disorders in any of the fingers will affect the stability or accuracy of the grip force (GF). To understand the functions of each finger in a dynamic grip exertion task, a GF following experiment with four individual fingers without thumb was designed. This study obtained four individual FFs from the distal phalanges with a cylindrical handle in dynamic GF following tasks. Ten healthy male subjects with similar hand sizes participated in the four-finger linear GF following tasks at different submaximal voluntary contraction (SMVC) levels. The total GF, individual FF, finger force contribution, and following error were subsequently calculated and analyzed. The statistics indicated the following: 1) the accuracy and stability of GF at low %MVC were significantly higher than those at high SMVC; 2) at low SMVC, the ability of the fingers to increase the GF was better than the ability to reduce it, but it was contrary at high SMVC; 3) when the target wave (TW) was changing, all four fingers strongly participated in the force exertion, but the participation of the little finger decreased significantly when TW remained stable; 4) the index finger and ring finger had a complementary relationship and played a vital role in the adjustment and control of GF. The middle finger and little finger had a minor influence on the force control and adjustment. In conclusion, each of the fingers had different functions in a GF following task. These findings can be used in the assessment of finger injury rehabilitation and for algorithms of precise control. Copyright © 2017 Elsevier Ltd. All rights reserved.

Comparison of Open and Closed Hand Fractures and the Effect of Urgent Operative Intervention.

PubMed

Minhas, Shobhit V; Catalano, Louis W

2018-06-13

To establish and compare the incidence of 30-day postoperative infection in surgically managed open and closed metacarpal and phalangeal fractures, and to determine whether open fractures treated urgently had a lower incidence of postoperative infection. We conducted a retrospective analysis of patient demographics, comorbidities, and 30-day infection rates of patients undergoing operative fixation of metacarpal, proximal, or middle phalanx fractures from 2008 to 2015 using the American College of Surgeons' National Surgical Quality Improvement Program database. A total of 3,506 patients were identified and patient variables and infection incidence were compared between open and closed injuries, as well as open injuries managed within 1 day of admission and those treated on an elective basis or treated more than 1 day after admission. Bivariate analysis was used to determine independent risk factors for postoperative infection. Although 34.2% of open hand fractures were taken urgently to the operating room, the diagnosis of open fractures along with nonurgent surgical treatment for open fractures was associated with a low incidence of postoperative infection. In addition, smoking was a risk factor for postoperative infection although anatomic location (phalanx vs metacarpal) was not. Patients undergoing surgery for metacarpal or proximal/middle phalangeal fractures are not at greater risk for infection based on the diagnosis of open fracture alone. In addition, patients with open fractures who are taken to the operating room more than 1 day from presentation did not have a higher incidence of infection. Smoking is associated with increased 30-day infection rates after surgery, and surgeons should identify these patients for preoperative risk stratification, counseling, and postoperative wound monitoring. Prognostic II. Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

A case of symbrachydactyly with oligodactyly.

PubMed

Seven, M; Yuksel, A; Ozkilic, A

2001-01-01

The term symbrachydactyly describes syndactyly accompanied by brachydactyly. Brachydactyly is seen in middle phalanges of both hands and feet and very short in length or absent. As for syndactyly it is a cutaneous type. It has always been observed unilaterally and sporadically. A familial type of this syndrome has also been reported. There have been many classifications of symbrachydactyly. Of these, Blauth classification is the most favored one. Yet these classifications have been inadequate to include many recently discovered other forms of symbrachydactyly. A three month old child was brought to the Istanbul University Genetic Research Center because of his abnormal hands and feet. He was the second child of a couple who had no kinship ties to each other. In the history of the family, there was no mention of any anomaly as such. There was a complete syndactyly involving the 3rd through the 5th fingers, partial syndactyly between the 2nd and 3rd, and the thumb was normal in the right hand. There was only one finger in the left hand. There was total syndactyly in four toes of the right foot with oligodactyly and absence of the big toe. The left foot had five toes with a complete syndactyly between the 2nd and the 3rd. Radiological observation indicated that the middle phalanges of both extremities were rudimentary or never developed. There was no osseous syndactyly. As observed in this case, oligodactylous type that is bilateral and involves both hands and feet together is very unusual. The purpose of this study is to present a rare case of this anomaly that requires a reassessment of symbrachydactyly and its traditional classifications.

Multi-finger synergies and the muscular apparatus of the hand.

PubMed

Cuadra, Cristian; Bartsch, Angelo; Tiemann, Paula; Reschechtko, Sasha; Latash, Mark L

2018-05-01

We explored whether the synergic control of the hand during multi-finger force production tasks depends on the hand muscles involved. Healthy subjects performed accurate force production tasks and targeted force pulses while pressing against loops positioned at the level of fingertips, middle phalanges, and proximal phalanges. This varied the involvement of the extrinsic and intrinsic finger flexors. The framework of the uncontrolled manifold (UCM) hypothesis was used to analyze the structure of inter-trial variance, motor equivalence, and anticipatory synergy adjustments prior to the force pulse in the spaces of finger forces and finger modes (hypothetical finger-specific control signals). Subjects showed larger maximal force magnitudes at the proximal site of force production. There were synergies stabilizing total force during steady-state phases across all three sites of force production; no differences were seen across the sites in indices of structure of variance, motor equivalence, or anticipatory synergy adjustments. Indices of variance, which did not affect the task (within the UCM), correlated with motor equivalent motion between the steady states prior to and after the force pulse; in contrast, variance affecting task performance did not correlate with non-motor equivalent motion. The observations are discussed within the framework of hierarchical control with referent coordinates for salient effectors at each level. The findings suggest that multi-finger synergies are defined at the level of abundant transformation between the low-dimensional hand level and higher dimensional finger level while being relatively immune to transformations between the finger level and muscle level. The results also support the scheme of control with two classes of neural variables that define referent coordinates and gains in back-coupling loops between hierarchical control levels.

Modeling the finger joint moments in a hand at the maximal isometric grip: the effects of friction.

PubMed

Wu, John Z; Dong, Ren G; McDowell, Thomas W; Welcome, Daniel E

2009-12-01

The interaction between the handle and operator's hand affects the comfort and safety of tool and machine operations. In most of the previous studies, the investigators considered only the normal contact forces. The effect of friction on the joint moments in fingers has not been analyzed. Furthermore, the observed contact forces have not been linked to the internal musculoskeletal loading in the previous experimental studies. In the current study, we proposed a universal model of a hand to evaluate the joint moments in the fingers during grasping tasks. The hand model was developed on the platform of the commercial software package AnyBody. Only four fingers (index, long, ring, and little finger) were included in the model. The anatomical structure of each finger is comprised of four phalanges (distal, middle, proximal, and metacarpal phalange). The simulations were performed using an inverse dynamics technique. The joint angles and the normal contact forces on each finger section reported by previous researchers were used as inputs, while the joint moments of each finger were predicted. The predicted trends of the dependence of the distal interphalangeal (DIP) and proximal interphalangeal (PIP) joint moments on the cylinder diameter agree with those of the contact forces on the fingers observed in the previous experimental study. Our results show that the DIP and PIP joint moments reach their maximums at a cylinder diameter of about 31mm, which is consistent with the trend of the finger contact forces measured in the experiments. The proposed approach will be useful for simulating musculoskeletal loading in the hand for occupational activities, thereby optimizing tool-handle design.

Phalangeal joints kinematics during ostrich (Struthio camelus) locomotion

PubMed Central

Ji, Qiaoli; Luo, Gang; Xue, Shuliang; Ma, Songsong; Li, Jianqiao

2017-01-01

The ostrich is a highly cursorial bipedal land animal with a permanently elevated metatarsophalangeal joint supported by only two toes. Although locomotor kinematics in walking and running ostriches have been examined, these studies have been largely limited to above the metatarsophalangeal joint. In this study, kinematic data of all major toe joints were collected from gaits with double support (slow walking) to running during stance period in a semi-natural setup with two selected cooperative ostriches. Statistical analyses were conducted to investigate the effect of locomotor gait on toe joint kinematics. The MTP3 and MTP4 joints exhibit the largest range of motion whereas the first phalangeal joint of the 4th toe shows the largest motion variability. The interphalangeal joints of the 3rd and 4th toes present very similar motion patterns over stance phases of slow walking and running. However, the motion patterns of the MTP3 and MTP4 joints and the vertical displacement of the metatarsophalangeal joint are significantly different during running and slow walking. Because of the biomechanical requirements, osctriches are likely to select the inverted pendulum gait at low speeds and the bouncing gait at high speeds to improve movement performance and energy economy. Interestingly, the motions of the MTP3 and MTP4 joints are highly synchronized from slow to fast locomotion. This strongly suggests that the 3rd and 4th toes really work as an “integrated system” with the 3rd toe as the main load bearing element whilst the 4th toe as the complementary load sharing element with a primary role to ensure the lateral stability of the permanently elevated metatarsophalangeal joint. PMID:28097064

Longevity in Calumma parsonii, the World's largest chameleon.

PubMed

Tessa, Giulia; Glaw, Frank; Andreone, Franco

2017-03-01

Large body size of ectothermic species can be correlated with high life expectancy. We assessed the longevity of the World's largest chameleon, the Parson's chameleon Calumma parsonii from Madagascar by using skeletochronology of phalanges taken from preserved specimens held in European natural history museums. Due to the high bone resorption we can provide only the minimum age of each specimen. The highest minimum age detected was nine years for a male and eight years for a female, confirming that this species is considerably long living among chameleons. Our data also show a strong correlation between snout-vent length and estimated age. Copyright © 2017 Elsevier Inc. All rights reserved.

Hip and nonvertebral fracture prediction in nursing home patients: role of bone ultrasound and bone marker measurements.

PubMed

Dobnig, Harald; Piswanger-Sölkner, Jutta Claudia; Obermayer-Pietsch, Barbara; Tiran, Andreas; Strele, Andrea; Maier, Elisabeth; Maritschnegg, Peter; Riedmüller, Gunter; Brueck, Carolin; Fahrleitner-Pammer, Astrid

2007-05-01

Absolute fracture risk in nursing home patients is the highest among the communities studied. Screening for high-risk patients in such an environment is usually difficult. The objective was to investigate whether quantitative bone ultrasound measurements and/or markers of bone turnover/metabolism help in predicting which patients will incur hip or nonvertebral fractures. In this prospective study, mobile teams enrolled 1664 female patients from 95 nursing homes in Austria. Calcaneal stiffness (n = 1117), radial speed of sound (SOS) (n = 1332), and phalangeal SOS (n = 1498) measurements were performed at baseline. Serum samples (n = 960) were analyzed for serum calcium and phosphate, 25 hydroxyvitamin D, PTH, osteocalcin, C-terminal telopeptide crosslinks, and osteoprotegerin (OPG). Patients were prospectively followed for hip and other nonvertebral fractures for 2 yr. A total of 117 hip fractures and 269 nonvertebral fractures developed during a mean observation period of 2 yr. Prevalence of vitamin D deficiency and secondary hyperparathyroidism was high. A history of a past fracture was significantly associated with a hazard ratio (HR) of 1.47 (95% confidence interval, 1.01-2.15) and 1.65 (1.26-2.16) for the development of hip and nonvertebral fractures, respectively. Cox regression analysis revealed a multivariate adjusted elevation in both hip [HR 1.30 (1.12-1.43)] and nonvertebral [HR 1.14 (1.02-1.25)] fracture risk for each sd decrease in calcaneal stiffness. Patients in the lowest quartile for calcaneal stiffness Z-score had 2.5 and 1.2 times higher rates of hip and nonvertebral fractures when compared with patients in the highest quartile. Fracture rates were not statistically associated with baseline radial or phalangeal SOS measurements or with serum osteocalcin, C-terminal telopeptide crosslinks, and OPG concentrations. When adjusted for bone mass, higher serum OPG levels were associated with fewer hip as well as nonvertebral fractures [HR 0.85 (0.73-0.99) and 0.89 (0.80-0.99) per increment of 1]. Higher serum phosphate levels indicated an increased hip [HR 1.54 (1.07-2.21)] and nonvertebral fracture risk [HR 1.40 (1.10-1.78) per increase of 1 mg/dl]. Body mass index was protective of hip fractures [HR 0.94 (0.90-0.98) per increase of 1] as well as medication with acetylsalicylic acid [HR 0.59 (0.36-0.95) for hip and 0.72 (0.52-0.99) for nonvertebral fractures]. In contrast, current use of glucocorticoids [HR 5.65 (1.77-18.0)] and opiates [HR 1.85 (1.18-2.92)] exerted a negative effect on prospective hip fracture risk. Calcaneal stiffness measurements proved to be useful in predicting hip fractures and to a lesser extent nonvertebral fractures in nursing home residents. Radial and phalangeal bone ultrasound measurements and baseline markers of bone turnover, however, were not indicative of future fracture risk in this population.

Prostaglandin PGE2: a possible mechanism for bone destruction in calcinosis circumscripta.

PubMed

Caniggia, A; Gennari, C; Vattimo, A; Runci, F; Bombardieri, S

1978-02-28

A patient showed evident osteolysis in phalanges and heavy periarticular calcium deposits of the fingers, wrists and toes which avidly took up 47Ca. The dense, white, tooth-paste like fluid contained in the periarticular calcium deposits has been studied by two different X-ray diffraction methods, by Ubatuba's bioassay for prostaglandin, by thin layer chromatography and by mass spectrometry. The calcium deposits were hydroxyapatite and prostaglandin PGE2 was detected in them. The bone resorption stimulating activity of PGE2 would be expected to result in increased bone destruction with release of calcium salts and this could be a working hypothesis of the pathogenesis of calcinosis circumscripta.

A new genus and species of treefrog from Medog, southeastern Tibet, China (Anura, Rhacophoridae)

PubMed Central

JIANG, Ke; YAN, Fang; WANG, Kai; ZOU, Da-Hu; LI, Cheng; CHE, Jing

2016-01-01

A new genus and species of threefrog is described from Medog, southeastern Tibet, China based on morphological and phylogenetic data. The new genus can be distinguished from other treefrog genera by the following combination of characters: (1) body size moderate, 45.0 mm in male; (2) snout rounded; (3) canthus rostralis obtuse and raised prominently, forming a ridge from nostril to anterior corner of eyes; (4) web rudimentary on fingers; (5) web moderately developed on toes; (6) phalange "Y" shaped, visible from dorsal side of fingers and toes; (7) skin of dorsal surfaces relatively smooth, scatted with small tubercles; (8) iris with a pale yellow, "X" shaped pattern of pigmentation. PMID:26828030

Cataract in a patient with 47,XYY sex chromosome aneuploidy.

PubMed

Medina-Andrade, A; Villanueva-Mendoza, C; Arenas, S; Cortés-González, V

2018-06-01

The case concerns a 16 year-old boy with a history of high myopia and unilateral congenital cataract, tall stature for age, facial dysmorphism, hypermobile metacarpal-phalangeal joints, as well as behavioural problems. The mother had a history of recurrent pregnancy loss. Chromosomal analysis of the peripheral blood lymphocytes reported 47,XYY. Patients with sex chromosome aneuploidy 47,XYY have higher risk of congenital malformations, although ophthalmological anomalies are unusual. Evaluation of patients with tall stature and behavioural problems should include a chromosomal analysis in order to determine the aetiology. Copyright © 2017 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

[Conservative treatment of metacarpal fracture].

PubMed

Prokop, A; Helling, H J; Kulus, S; Rehm, K E

2002-01-01

Conservative treatment of meatacarpale fracture is recommended if there are no joint displacement, rotation failures, displacement over 30 degrees ad axim and shortening over 5 mm. Operative procedures should be done in open fractures and serial of fractures of metacarpale bones. Early functionally treatment should be done in stable, not displaced fractures. Cast can be used only for a short time in full extended position of fingers and flexion in metacarpo-phalangeal joint in 60-90 degrees. Twin-tapes after reduction of edema allowed free range of motion by fixed rotation. Closed reduction of displaced fractures of fifth metacarpal bone (boxer's fracture) isn't successful. Cases with displacement over 30 degrees may be operatively treated by intramedullary stabilization.

[Treatment of metacarpal fractures].

PubMed

Prokop, A; Jubel, A; Helling, H J; Kulus, S; Rehm, K E

2002-09-01

Conservative treatment of metacarpal fractures is recommended if there is no joint displacement, malrotation, displacement of over 30 degrees ad axim and shortening of over 5 mm. Surgery should be performed in open fractures and serial fractures of metacarpal bone. Early functional treatment should be carried out in stable, not displaced fractures. A cast can be used for a short period in full extended position of fingers and flexion in metacarpo-phalangeal joint in 60 - 90 degrees. Twin-tape fixation allows functional treatment after soft-tissue swelling has disappeared. Closed reduction of displaced fractures of the fifth metacarpal bone (boxer's fracture) is not successful. Cases with displacement of over 30 degrees may be treated surgically by intramedullary stabilisation.

Ilizarov distraction-lengthening in congenital anomalies of the upper limb.

PubMed

Hülsbergen-Krüger, S; Preisser, P; Partecke, B D

1998-04-01

Nine patients underwent Ilizarov distraction-lengthening for congenital anomalies. All were late cases and had undergone other procedures. In five radial club hand patients with very short forearms, we achieved an average 5.8 cm increase in length with each distraction cycle. In two patients with symbrachydactyly of the cleft hand type, we achieved pinch grip between a radial and an ulnar digit by lengthening the short ray. Another case of the monodactyly type in which we tried to lengthen three transplanted proximal toe phalanges ended in failure. A soft tissue distraction was attempted in a case of camptodactyly but failed. We report the problems we encountered and suggest some solutions.

Consequences of Location-Dependent Organ of Corti Micro-Mechanics

PubMed Central

Liu, Yanju; Gracewski, Sheryl M.; Nam, Jong-Hoon

2015-01-01

The cochlea performs frequency analysis and amplification of sounds. The graded stiffness of the basilar membrane along the cochlear length underlies the frequency-location relationship of the mammalian cochlea. The somatic motility of outer hair cell is central for cochlear amplification. Despite two to three orders of magnitude change in the basilar membrane stiffness, the force capacity of the outer hair cell’s somatic motility, is nearly invariant over the cochlear length. It is puzzling how actuators with a constant force capacity can operate under such a wide stiffness range. We hypothesize that the organ of Corti sets the mechanical conditions so that the outer hair cell’s somatic motility effectively interacts with the media of traveling waves—the basilar membrane and the tectorial membrane. To test this hypothesis, a computational model of the gerbil cochlea was developed that incorporates organ of Corti structural mechanics, cochlear fluid dynamics, and hair cell electro-physiology. The model simulations showed that the micro-mechanical responses of the organ of Corti are different along the cochlear length. For example, the top surface of the organ of Corti vibrated more than the bottom surface at the basal (high frequency) location, but the amplitude ratio was reversed at the apical (low frequency) location. Unlike the basilar membrane stiffness varying by a factor of 1700 along the cochlear length, the stiffness of the organ of Corti complex felt by the outer hair cell remained between 1.5 and 0.4 times the outer hair cell stiffness. The Y-shaped structure in the organ of Corti formed by outer hair cell, Deiters cell and its phalange was the primary determinant of the elastic reactance imposed on the outer hair cells. The stiffness and geometry of the Deiters cell and its phalange affected cochlear amplification differently depending on the location. PMID:26317521

[Metacarpophalangeal and carpal numeric indices to calculate bone age and predict adult size].

PubMed

Ebrí Torné, B; Ebrí Verde, I

2012-04-01

This work presents new numerical methods from the meta-carpal-phalangeal and carpal indexes, for calculating bone age. In addition, these new methods enable the adult height to be predicted using multiple regression equations. The longitudinal case series studied included 160 healthy children from Zaragoza, of both genders, aged between 6 months and 20 years, and studied annually, including the radiological study. For the statistical analysis the statistical package "Statistix", as well as the Excel program, was used. The new indexes are closely co-related to the chronological age, thus leading to predictive equations for the calculation of the bone age of children up to 20 years of age. In addition, it presents particular equations for up to 4 years of age, in order to optimise the diagnosis at these early ages. The resulting bones ages can be applied to numerical standard deviation tables, as well as to an equivalences chart, which directly gives us the ossification diagnosis. The predictive equations of adult height allow a reliable forecast of the future height of the studied child. These forecasts, analysed by the Student test did not show significant differences as regards the adult height that children of the case series finally achieved. The results can be obtained with a pocket calculator or through free software available for the reader. For the first time, and using a centre-developed and non-foreign methods, bones age standards and adult height predictive equations for the study of children, are presented. We invite the practitioner to use these meta-carpal-phalangeal and carpal methods in order to achieve the necessary experience to apply it to a healthy population and those with different disorders. Copyright © 2011 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

Vertical leaping mechanics of the Lesser Egyptian Jerboa reveal specialization for maneuverability rather than elastic energy storage.

PubMed

Moore, Talia Y; Rivera, Alberto M; Biewener, Andrew A

2017-01-01

Numerous historical descriptions of the Lesser Egyptian jerboa, Jaculus jaculus , a small bipedal mammal with elongate hindlimbs, make special note of their extraordinary leaping ability. We observed jerboa locomotion in a laboratory setting and performed inverse dynamics analysis to understand how this small rodent generates such impressive leaps. We combined kinematic data from video, kinetic data from a force platform, and morphometric data from dissections to calculate the relative contributions of each hindlimb muscle and tendon to the total movement. Jerboas leapt in excess of 10 times their hip height. At the maximum recorded leap height (not the maximum observed leap height), peak moments for metatarso-phalangeal, ankle, knee, and hip joints were 13.1, 58.4, 65.1, and 66.9 Nmm, respectively. Muscles acting at the ankle joint contributed the most work (mean 231.6 mJ / kg Body Mass) to produce the energy of vertical leaping, while muscles acting at the metatarso-phalangeal joint produced the most stress (peak 317.1 kPa). The plantaris, digital flexors, and gastrocnemius tendons encountered peak stresses of 25.6, 19.1, and 6.0 MPa, respectively, transmitting the forces of their corresponding muscles (peak force 3.3, 2.0, and 3.8 N, respectively). Notably, we found that the mean elastic energy recovered in the primary tendons of both hindlimbs comprised on average only 4.4% of the energy of the associated leap. The limited use of tendon elastic energy storage in the jerboa parallels the morphologically similar heteromyid kangaroo rat, Dipodomys spectabilis . When compared to larger saltatory kangaroos and wallabies that sustain hopping over longer periods of time, these small saltatory rodents store and recover less elastic strain energy in their tendons. The large contribution of muscle work, rather than elastic strain energy, to the vertical leap suggests that the fitness benefit of rapid acceleration for predator avoidance dominated over the need to enhance locomotor economy in the evolutionary history of jerboas.

A Low-Cost Hand Trainer Device Based On Microcontroller Platform

NASA Astrophysics Data System (ADS)

Sabor, Muhammad Akmal Mohammad; Thamrin, Norashikin M.

2018-03-01

Conventionally, the rehabilitation equipment used in the hospital or recovery center to treat and train the muscle of the stroke patient is implementing the pneumatic or compressed air machine. The main problem caused by this equipment is that the arrangement of the machine is quite complex and the position of it has been locked and fixed, which can cause uncomfortable feeling to the patients throughout the recovery session. Furthermore, the harsh movement from the machine could harm the patient as it does not allow flexibility movement and the use of pneumatic actuator has increased the gripping force towards the patient which could hurt them. Therefore, the main aim of this paper is to propose the development of the Bionic Hand Trainer based on Arduino platform, for a low-cost solution for rehabilitation machine as well as allows flexibility and smooth hand movement for the patients during the healing process. The scope of this work is to replicate the structure of the hand only at the fingers structure that is the phalanges part, which inclusive the proximal, intermediate and distal of the fingers. In order to do this, a hand glove is designed by equipping with flex sensors at every finger and connected them to the Arduino platform. The movement of the hand will motorize the movement of the dummy hand that has been controlled by the servo motors, which have been equipped along the phalanges part. As a result, the bending flex sensors due to the movement of the fingers has doubled up the rotation of the servo motors to mimic this movement at the dummy hand. The voltage output from the bending sensors are ranging from 0 volt to 5 volts, which are suitable for low-cost hand trainer device implementation. Through this system, the patient will have the power to control their gripping operation slowly without having a painful force from the external actuators throughout the rehabilitation process.

Analysis of joint force and torque for the human and non-human ape foot during bipedal walking with implications for the evolution of the foot.

PubMed

Wang, Weijie; Abboud, Rami J; Günther, Michael M; Crompton, Robin H

2014-08-01

The feet of apes have a different morphology from those of humans. Until now, it has merely been assumed that the morphology seen in humans must be adaptive for habitual bipedal walking, as the habitual use of bipedal walking is generally regarded as one of the most clear-cut differences between humans and apes. This study asks simply whether human skeletal proportions do actually enhance foot performance during human-like bipedalism, by examining the influence of foot proportions on force, torque and work in the foot joints during simulated bipedal walking. Skeletons of the common chimpanzee, orangutan, gorilla and human were represented by multi-rigid-body models, where the components of the foot make external contact via finite element surfaces. The models were driven by identical joint motion functions collected from experiments on human walking. Simulated contact forces between the ground and the foot were found to be reasonably comparable with measurements made during human walking using pressure- and force-platforms. Joint force, torque and work in the foot were then predicted. Within the limitations of our model, the results show that during simulated human-like bipedal walking, (1) the human and non-human ape (NHA) feet carry similar joint forces, although the distributions of the forces differ; (2) the NHA foot incurs larger joint torques than does the human foot, although the human foot has higher values in the first tarso-metatarsal and metatarso-phalangeal joints, whereas the NHA foot incurs higher values in the lateral digits; and (3) total work in the metatarso-phalangeal joints is lower in the human foot than in the NHA foot. The results indicate that human foot proportions are indeed well suited to performance in normal human walking. © 2014 Anatomical Society.

Five- and 10-Year Follow-Up of Nonvascularized Toe Phalanx Transfers.

PubMed

Kawabata, Hidehiko; Tamura, Daisuke

2018-05-01

The purpose of this study was to evaluate long-term outcomes of nonvascularized toe phalanx transfer. We retrospectively reviewed 54 nonvascularized toe phalanx transfers in 29 children with symbrachydactyly. Forty-seven transfers in 24 children were evaluated at 5-year follow-up and 27 transfers in 14 children were evaluated at 10-year follow-up. We recorded the incidence of the early physeal closure and the length of the transferred toe phalanx on plain radiographs at 5- and 10-year follow-up. Growth rate in the first 5 years and the following 5 years were calculated. Function of the metacarpophalangeal joint (motion, stability, and alignment) was also evaluated. The mean age at surgery was 1.5 years. Seven toe phalanges were trimmed because the skin pocket was tight. Five transfers required revision surgery for partial necrosis of the skin pocket. At 5-year follow-up, the physis was closed in 23%, and at 10 years, 78% of physes were closed. The phalanx length was 87% of expected at 5-year follow-up and 71% at 10-year follow-up. Growth rate was 0.83 mm/y in the first 5 years and 0.22 mm/y in the following 5 years. Active motion was rated as good in 24, fair in 7, and poor in 16. Stability and alignment were rated as good in 37 and 33, fair in 8 and 5, and poor in 2 and 9, respectively. Nonvascularized toe phalanx transfer offered a relatively simple method to lengthen short digits and to provide satisfactory function. The transferred toe phalanges grew at a near-normal rate in the first 5 years, but the growth rate decreased between 5 and 10 years. Therapeutic IV. Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Analysis of joint force and torque for the human and non-human ape foot during bipedal walking with implications for the evolution of the foot

PubMed Central

Wang, Weijie; Abboud, Rami J; Günther, Michael M; Crompton, Robin H

2014-01-01

The feet of apes have a different morphology from those of humans. Until now, it has merely been assumed that the morphology seen in humans must be adaptive for habitual bipedal walking, as the habitual use of bipedal walking is generally regarded as one of the most clear-cut differences between humans and apes. This study asks simply whether human skeletal proportions do actually enhance foot performance during human-like bipedalism, by examining the influence of foot proportions on force, torque and work in the foot joints during simulated bipedal walking. Skeletons of the common chimpanzee, orangutan, gorilla and human were represented by multi-rigid-body models, where the components of the foot make external contact via finite element surfaces. The models were driven by identical joint motion functions collected from experiments on human walking. Simulated contact forces between the ground and the foot were found to be reasonably comparable with measurements made during human walking using pressure- and force-platforms. Joint force, torque and work in the foot were then predicted. Within the limitations of our model, the results show that during simulated human-like bipedal walking, (1) the human and non-human ape (NHA) feet carry similar joint forces, although the distributions of the forces differ; (2) the NHA foot incurs larger joint torques than does the human foot, although the human foot has higher values in the first tarso-metatarsal and metatarso-phalangeal joints, whereas the NHA foot incurs higher values in the lateral digits; and (3) total work in the metatarso-phalangeal joints is lower in the human foot than in the NHA foot. The results indicate that human foot proportions are indeed well suited to performance in normal human walking. PMID:24925580

[The VB system: a new modular osteosynthesis material involving both screws and wires].

PubMed

Dubert, T; Valenti, P; Dinh, A; Osman, N

2002-01-01

VB is an osteosynthesis system for the stabilisation of small fragments, which combines the benefits of both wires and screws. It is a modular system comprising a threaded pin and a ring. The threaded pin is first positioned. Then a ring is grasped and opened by the progressive angulation of a screwdriver. Still anchored on the screwdriver, the ring slides easily on the pin. It is clamped on the pin by simply removing the screwdriver and the pin is then cut. This modular system includes 1.8 and 1.1 mm pins and different types of rings (threaded or non threaded, with or without collars). The system is easy to handle and can be introduced using an open or percutaneous technique, allowing compression or distraction. Our preliminary series, performed in accordance with National clinical trial protocol (Huriet) consisted of 50 cases in 24 patients (five women and 19 men) with an average age of 48 years, and a follow-up of more than six months. Fourteen cases of fractures (28 implants) were treated as emergencies (two radial heads, one capitellum, one trochlea of the humerus, seven distal radius fractures, one trapezium, two metacarpals) and 12 cases (22 implants) were elective cases: arthrodesis (one trapezo-metacarpal, one intermetacarpal, two interphalangeal, two carpal), non-union (six scaphoids, one phalangeal) and one phalangeal malunion. Hardware removal was performed in 16 cases. No implant failure has been detected. One case, a DIP arthrodesis, had a suspicion of sepsis which led to the removal of the implants at six weeks. The results of this study have convinced us of the merits of the system, which combines the advantages of both wires and screws. The system allows the user to perform either distraction or compression, and to adjust the force by hand. Compared to the fixed amount of compression produced by lag screws, this feature seems to be a real step forward.

Microstructure and Cross-Sectional Shape of Limb Bones in Great Horned Owls and Red-Tailed Hawks: How Do These Features Relate to Differences in Flight and Hunting Behavior?

PubMed Central

Marelli, Crystal A.; Simons, Erin L. R.

2014-01-01

The Red-tailed Hawk and Great Horned Owl are two species of raptor that are similar in body size, diet, and habitat. Both species use their hindlimbs during hunting, but differ in foot morphology, how they approach and immobilize prey, and the average size of prey captured. They also differ in primary flight style: the Red-tailed Hawk uses static soaring and the Great Horned Owl uses flap-gliding. The objectives of this study were to characterize the microstructure and cross-sectional shape of limb bones of these species and examine the relationship with flight and hunting behaviors. The mid-shaft of six limb bones from six individuals of each species was sampled. The degree of bone laminarity (proportion of circular primary vascular canals) and cross-sectional geometric parameters were calculated. In both species, the humerus and femur exhibited features that suggest high resistance to torsional loading, whereas the tibiotarsus and phalanges had a shape more likely to resist compression and bending in a specific plane. The femur of the Red-tailed Hawk exhibited higher laminarity and larger polar moment of area than that of the Great Horned Owl. The tibiotarsus was more elliptical than that of the Great Horned Owl. The hawk approaches prey from a more horizontal axis, takes prey of greater mass, and is more likely to pursue prey on the ground, which could potentially be causing more torsional loads on the femur and bending loads on the tibiotarsus. In addition, differences in polar moment of area of the phalanges between the species could relate to differences in foot morphology or digit length. The humerus and ulna of the flap-gliding Great Horned Owl are more elliptical than the static soaring Red-tailed Hawk, a shape that may better resist the bending loads associated with a larger amount of flapping. PMID:25162595

Microstructure and cross-sectional shape of limb bones in Great Horned Owls and Red-tailed Hawks: how do these features relate to differences in flight and hunting behavior?

PubMed

Marelli, Crystal A; Simons, Erin L R

2014-01-01

The Red-tailed Hawk and Great Horned Owl are two species of raptor that are similar in body size, diet, and habitat. Both species use their hindlimbs during hunting, but differ in foot morphology, how they approach and immobilize prey, and the average size of prey captured. They also differ in primary flight style: the Red-tailed Hawk uses static soaring and the Great Horned Owl uses flap-gliding. The objectives of this study were to characterize the microstructure and cross-sectional shape of limb bones of these species and examine the relationship with flight and hunting behaviors. The mid-shaft of six limb bones from six individuals of each species was sampled. The degree of bone laminarity (proportion of circular primary vascular canals) and cross-sectional geometric parameters were calculated. In both species, the humerus and femur exhibited features that suggest high resistance to torsional loading, whereas the tibiotarsus and phalanges had a shape more likely to resist compression and bending in a specific plane. The femur of the Red-tailed Hawk exhibited higher laminarity and larger polar moment of area than that of the Great Horned Owl. The tibiotarsus was more elliptical than that of the Great Horned Owl. The hawk approaches prey from a more horizontal axis, takes prey of greater mass, and is more likely to pursue prey on the ground, which could potentially be causing more torsional loads on the femur and bending loads on the tibiotarsus. In addition, differences in polar moment of area of the phalanges between the species could relate to differences in foot morphology or digit length. The humerus and ulna of the flap-gliding Great Horned Owl are more elliptical than the static soaring Red-tailed Hawk, a shape that may better resist the bending loads associated with a larger amount of flapping.

The dowel technique for first metatarso-phalangeal joint arthrodesis in revision surgery with bone loss.

PubMed

Malagelada, Francesc; Welck, Matthew J; Clark, Callum

2017-02-27

The operative management of failed first metatarso-phalangeal joint (MTPJ) surgery is often complicated by bone loss and shortening of the hallux. Restoration of first ray length and alignment often cannot be achieved with in situ fusion and reconstruction techniques with bone graft are therefore required. We present a novel technique of longitudinal (proximo-distal) bone dowel arthrodesis for first MTPJ arthrodesis with bone loss. Between August 2007 and February 2015, eight patients have been treated by the senior author with this technique. The mean age at surgery was 60.5 years (range 45-80) with seven females and one male. Index surgery was MTPJ arthrodesis (three patients), Keller excision arthroplasty (two patients), MTPJ hemiarthroplasty (two patients) and silastic arthroplasty (one patient). Clinical and radiological fusion was assessed and other radiological measurements included hallux valgus angle (HVA) and length of the hallux (LOH). All patients achieved fusion at a mean of 9.3 weeks (range 6-12) from surgery and only one patient required removal of metalwork. There were no major complications. The HVA improved in all cases from 21.4±2.8 pre-operatively to 11.6±3.5 post-operatively (p>0.05). The LOH also increased in all cases from 82.1±8.3mm to 86.7±8.2mm (p>0.05). The subgroup of patients who were revised from an arthroplasty, where maintenance of length rather than increase in length was desirable (hemiarthroplasty, silastic) had significantly lower increase in LOH than those revised from a non-arthroplasty index surgery (arthrodesis, Keller) (p=0.029). The dowel technique is successful for first MTPJ arthrodesis revision surgery with optimal union rates and satisfactory radiographic and clinical outcomes. It is an effective and versatile option for managing bone loss and deformity of the hallux. Copyright © 2017 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

Development of a biometric method to estimate age on hand radiographs.

PubMed

Remy, Floriane; Hossu, Gabriela; Cendre, Romain; Micard, Emilien; Mainard-Simard, Laurence; Felblinger, Jacques; Martrille, Laurent; Lalys, Loïc

2017-02-01

Age estimation of living individuals aged less than 13, 18 or 21 years, which are some relevant legal ages in most European countries, is currently problematic in the forensic context. Thus, numerous methods are available for legal authorities, although their efficiency can be discussed. For those reasons, we aimed to propose a new method, based on the biometric analysis of hand bones. 451 hand radiographs of French individuals under the age of 21 were retrospectively analyzed. This total sample was divided into three subgroups bounded by the relevant legal ages previously mentioned: 0-13, 13-18 and 18-21 years. On these radiographs, we numerically applied the osteometric board method used in anthropology, by including each metacarpal and proximal phalange of the five hand rays in the smallest rectangle possible. In that we can access their length and width information thanks to a measurement protocol developed precisely for our treatment with the ORS Visual ® software. Then, a statistical analysis was performed from these biometric data: a Linear Discriminant Analysis (LDA) evaluated the probability for an individual to belong to one of the age group (0-13, 13-18 or 18-21); and several multivariate regression models were tested for the establishment of age estimation formulas for each of these age groups. The mean Correlation Coefficient between chronological age and both lengths and widths of hand bones is equal to 0.90 for the total sample. Repeatability and reproducibility were assessed. The LDA could more easily predict the belonging to the 0-13 age group. Age can be estimated with a mean standard error which never exceeds 1 year for the 95% confidence interval. Finally, compared to the literature, we can conclude that estimating an age from the biometric information of metacarpals and proximal phalanges is promising. Copyright © 2016. Published by Elsevier B.V.

Genetic background of supernumerary teeth.

PubMed

Subasioglu, Asli; Savas, Selcuk; Kucukyilmaz, Ebru; Kesim, Servet; Yagci, Ahmet; Dundar, Munis

2015-01-01

Supernumerary teeth (ST) are odontostomatologic anomaly characterized by as the existence excessive number of teeth in relation to the normal dental formula. This condition is commonly seen with several congenital genetic disorders such as Gardner's syndrome, cleidocranial dysostosis and cleft lip and palate. Less common syndromes that are associated with ST are; Fabry Disease, Ellis-van Creveld syndrome, Nance-Horan syndrome, Rubinstein-Taybi Syndrome and Trico-Rhino-Phalangeal syndrome. ST can be an important component of a distinctive disorder and an important clue for early diagnosis. Certainly early detecting the abnormalities gives us to make correct management of the patient and also it is important for making well-informed decisions about long-term medical care and treatment. In this review, the genetic syndromes that are related with ST were discussed.

Poland's syndrome with unusual hand and chest anomalies: a rare case report.

PubMed

Yadav, G K; Lal, S; Dange, N; Marwah, K G; Singh, J P

2014-01-01

Poland's syndrome is a rare congenital anomaly consisting of a unilateral absence of the pectoralis major, ipsilateral muscle, hand anomaly and occasionally associated other malformations of the chest wall and breast. Many structural and functional abnormalities have been described in association with this syndrome. We report an incidentally diagnosed case in a 27-year-old male patient who presented to us with symbrachydactyly. In addition to this, anterior depression of 2nd, 3rd and 4th ribs and bifid (forked) 5th rib was present on radiological investigations. The body of sternum was short and deformed on the right side with absence of xiphoid process. All middle phalanges were absent on righthand. It is a rare variant of Poland's syndrome.

Image analysis for skeletal evaluation of carpal bones

NASA Astrophysics Data System (ADS)

Ko, Chien-Chuan; Mao, Chi-Wu; Lin, Chi-Jen; Sun, Yung-Nien

1995-04-01

The assessment of bone age is an important field to the pediatric radiology. It provides very important information for treatment and prediction of skeletal growth in a developing child. So far, various computerized algorithms for automatically assessing the skeletal growth have been reported. Most of these methods made attempt to analyze the phalangeal growth. The most fundamental step in these automatic measurement methods is the image segmentation that extracts bones from soft-tissue and background. These automatic segmentation methods of hand radiographs can roughly be categorized into two main approaches that are edge and region based methods. This paper presents a region-based carpal-bone segmentation approach. It is organized into four stages: contrast enhancement, moment-preserving thresholding, morphological processing, and region-growing labeling.

A new diminutive frog species of Adelophryne (Amphibia: Anura: Eleutherodactylidae) from the Atlantic Forest, southeastern Brazil.

PubMed

Lourenço-de-Moraes, Ricardo; Ferreira, Rodrigo Barbosa; Fouquet, Antoine; Bastos, Rogério Pereira

2014-08-04

The genus Adelophryne is composed of diminutive frogs occurring in northern Amazonia and the Atlantic Forest. Herein we describe a new species of Adelophryne found in the leaf litter of primary and secondary forests in the mountainous region of Espírito Santo state, southeastern Brazil. The new species is characterized by its small body size, two phalanges in the finger IV, and a glandular ridge line that runs from the posterior part of eye to the insertion of the forelimb. This species is sensitive to edge effect and conversion of native forest into coffee and Eucalyptus plantations and may be listed as Endangered (EN) under B1ab(iii) criteria of the IUCN Red List.

Genetic background of supernumerary teeth

PubMed Central

Subasioglu, Asli; Savas, Selcuk; Kucukyilmaz, Ebru; Kesim, Servet; Yagci, Ahmet; Dundar, Munis

2015-01-01

Supernumerary teeth (ST) are odontostomatologic anomaly characterized by as the existence excessive number of teeth in relation to the normal dental formula. This condition is commonly seen with several congenital genetic disorders such as Gardner's syndrome, cleidocranial dysostosis and cleft lip and palate. Less common syndromes that are associated with ST are; Fabry Disease, Ellis-van Creveld syndrome, Nance-Horan syndrome, Rubinstein-Taybi Syndrome and Trico–Rhino–Phalangeal syndrome. ST can be an important component of a distinctive disorder and an important clue for early diagnosis. Certainly early detecting the abnormalities gives us to make correct management of the patient and also it is important for making well-informed decisions about long-term medical care and treatment. In this review, the genetic syndromes that are related with ST were discussed. PMID:25713500

Reactive Periostitis from Inhalant Abuse.

PubMed

Hock, Lauren E; Honkanen, Iiro; Fiordellisi, Wendy; Bettendorf, Brittany

2018-04-16

The patient, a 36-year-old woman, presented with a 6-week history of swollen hands and fingers and associated arthralgia. She had a history of polysubstance abuse. The arthralgia and swelling started one month after she began inhaling two cans of "Dust-Off" (1,1-difluoroethane) daily. Physical examination revealed tender proximal and middle phalanges of all fingers bilaterally with bulbous appearance (A). There was no clubbing. Radiography of the hands revealed diffuse reactive periostitis with discrete layering of periosteal bone formation without bony destruction (B). TSH was normal. Serum alkaline phosphatase was 854 U/L. Computed tomography of the chest, abdomen, and pelvis showed no evidence of malignancy or pulmonary disease This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Interstitial 1q21.1 Microdeletion Is Associated with Severe Skeletal Anomalies, Dysmorphic Face and Moderate Intellectual Disability.

PubMed

Gamba, Bruno F; Zechi-Ceide, Roseli M; Kokitsu-Nakata, Nancy M; Vendramini-Pittoli, Siulan; Rosenberg, Carla; Krepischi Santos, Ana C V; Ribeiro-Bicudo, Lucilene; Richieri-Costa, Antonio

2016-11-01

We report on a Brazilian patient with a 1.7-Mb interstitial microdeletion in chromosome 1q21.1. The phenotypic characteristics include microcephaly, a peculiar facial gestalt, cleft lip/palate, and multiple skeletal anomalies represented by malformed phalanges, scoliosis, abnormal modeling of vertebral bodies, hip dislocation, abnormal acetabula, feet anomalies, and delayed neuropsychological development. Deletions reported in this region are clinically heterogeneous, ranging from subtle phenotypic manifestations to severe congenital heart defects and/or neurodevelopmental findings. A few genes within the deleted region are associated with congenital anomalies, mainly the RBM8A , DUF1220 , and HYDIN2 paralogs. Our patient presents with a spectrum of unusual malformations of 1q21.1 deletion syndrome not reported up to date.

Interstitial 1q21.1 Microdeletion Is Associated with Severe Skeletal Anomalies, Dysmorphic Face and Moderate Intellectual Disability

PubMed Central

Gamba, Bruno F.; Zechi-Ceide, Roseli M.; Kokitsu-Nakata, Nancy M.; Vendramini-Pittoli, Siulan; Rosenberg, Carla; Krepischi Santos, Ana C.V.; Ribeiro-Bicudo, Lucilene; Richieri-Costa, Antonio

2016-01-01

We report on a Brazilian patient with a 1.7-Mb interstitial microdeletion in chromosome 1q21.1. The phenotypic characteristics include microcephaly, a peculiar facial gestalt, cleft lip/palate, and multiple skeletal anomalies represented by malformed phalanges, scoliosis, abnormal modeling of vertebral bodies, hip dislocation, abnormal acetabula, feet anomalies, and delayed neuropsychological development. Deletions reported in this region are clinically heterogeneous, ranging from subtle phenotypic manifestations to severe congenital heart defects and/or neurodevelopmental findings. A few genes within the deleted region are associated with congenital anomalies, mainly the RBM8A, DUF1220, and HYDIN2 paralogs. Our patient presents with a spectrum of unusual malformations of 1q21.1 deletion syndrome not reported up to date. PMID:27920638

Genoa Syndrome and Central Diabetes Insipidus: A Case Report

PubMed Central

Şıklar, Zeynep; Erdeve, Şenay Savaş; Berberoğlu, Merih; Deda, Gülhiz; Tıraş, Serap Teber; Fitöz, Suat; Öçal, Gönül

2010-01-01

Genoa syndrome was first described by Camera et al in 1993 in two patients with semilobar holoprosencephaly (HPE), craniosynostosis and abnormal small hands with cone−shaped epiphyses and hypoplastic terminal phalanges of fingers (OMIM: 601370). In 2001, Lapunzina et al reported a case of craniosynostosis and HPE associated with several other malformations and suggested that these findings could be attributed to a severe form of Genoa syndrome or to a newly recognized syndrome. Endocrinopathies in association with HPE are frequently reported in the literature. Diabetes insipidus, hypothyroidism, hypocortisolism, and growth hormone deficiency are frequently associated with HPE. We here report a case of semilobar HPE, craniosynostosis and cleft lip/palate, possibly a case of Genoa syndrome, associated with central diabetes insipidus. Conflict of interest:None declared. PMID:21274346

On-top plasty using a free metacarpal head graft for lengthening of proximal phalanx in symbrachydactyly--a case report.

PubMed

Iba, Kousuke; Wada, Takuro; Yamashita, Toshihiko

2013-01-01

A three-year old patient with symbrachydactyly (didactyly type) presented with a little finger that was too short to allow pinching and consisting of a floppy soft-tissue envelope with hypoplastic phalanges, although the thumb was functional. As the proximal phalanx was too small to permit distraction lengthening or conventional bone grafting, on-top plasty using a 4th metacarpal graft with a cartilage head was undertaken for lengthening the proximal phalanx of the little finger for pinch reconstruction. At ten weeks after surgery, the patient achieved satisfactory pinch function due to the lengthened and bone-stabilised postoperative digit and reconstruction of functional proximal interphalangeal joint. In addition, the grafted metacarpal demonstrated satisfactory bone growth throughout the six-year follow-up period.

Longitudinal bracketed epiphysis of proximal phalanx of the great toe with congenital hallux varus managed simultaneously with monorail external fixator: a case report.

PubMed

Verma, Vineet; Batra, Amit; Singla, Rohit; Gogna, Paritosh; Magu, Narender; Gupta, Rakesh

2014-02-01

Longitudinal bracketed epiphysis (delta phalanx) is a rare congenital anomaly that affects phalanges in the hand more commonly than toes. We present a rare case of congenital hallux varus with longitudinal bracketed epiphysis of proximal phalanx with bifid distal phalanx of the great toe, which was managed with monorail type of external fixator. To the best of our knowledge, this is the first report of its successful implementation in simultaneous treatment of longitudinal bracketed epiphysis of the proximal phalanx of the great toe and hallux varus. Apart from adding to the literature a case of rare subtype of delta phalanx with hallux varus, the present study highlights the role of a reliable alternative in its management.

Comparison of total-body calcium with radiographic and photon absorptiometry measurement of appendicular bone mineral content. [Comparison of findings in patients with primary osteoporosis and healthy marathon runners

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zanzi, I; Colbert, C; Bachtell, R

1978-01-01

Two groups of investigators utilized three techniques for evaluating bone mineral mass. In one institution, total-body calcium by total body neutron activation analysis, and bone mineral content of the radius by photon absorptiometry were measured concomitantly. In the other institution, the mean bone mineral content of the three inner phalanges of the left hand was measured by radiographic absorptiometry. These techniques were applied to two groups of subjects: 16 patients with primary osteoporosis and 14 healthy marathon runners. The higher correlation found in osteoporotic patients may be related to the diffuse nature of this condition and to differences in themore » distribution of skeletal mass in the marathon runners.« less

New evidence from China for the nature of the pterosaur evolutionary transition

NASA Astrophysics Data System (ADS)

Wang, Xiaoli; Jiang, Shunxing; Zhang, Junqiang; Cheng, Xin; Yu, Xuefeng; Li, Yameng; Wei, Guangjin; Wang, Xiaolin

2017-02-01

Pterosaurs are extinct flying reptiles, the first vertebrates to achieve powered flight. Our understanding of the evolutionary transition between basal, predominantly long-tailed forms to derived short-tailed pterodactyloids remained poor until the discovery of Wukongopterus and Darwinopterus in western Liaoning, China. In this paper we report on a new genus and species, Douzhanopterus zhengi, that has a reduced tail, 173% the length of the humerus, and a reduced fifth pedal digit, whose first phalange is ca. 20% the length of metatarsal III, both unique characters to Monofenestra. The morphological comparisons and phylogenetic analysis presented in this paper demonstrate that Douzhanopterus is the sister group to the ‘Painten pro-pterodactyloid’ and the Pterodactyloidea, reducing the evolutionary gap between long- and short-tailed pterosaurs.

First metatarsal-phalangeal joint arthrodesis: a biomechanical assessment of stability.

PubMed

Politi, Joel; John, Hayes; Njus, Glen; Bennett, Gordon L; Kay, David B

2003-04-01

First metatarsal phalangeal joint (MTP) arthrodesis is a commonly performed procedure for the treatment of hallux rigidus, severe and recurrent bunion deformities, rheumatoid arthritis and other less common disorders of the joint. There are different techniques of fixation of the joint to promote arthrodesis including oblique lag screw fixation, lag screw and dorsal plate fixation, crossed Kirschner wires, dorsal plate fixation alone and various types of external fixation. Ideally the fixation method should be reproducible, lead to a high rate of fusion, and have a low incidence of complications. In the present study, we compared the strength of fixation of five commonly utilized techniques of first MTP joint arthrodesis. These were: 1. Surface excision with machined conical reaming and fixation with a 3.5 mm cortical interfragmentary lag screw. 2. Surface excision with machined conical reaming and fixation with crossed 0.062 Kirschner wires. 3. Surface excision with machined conical reaming and fixation with a 3.5 mm cortical lag screw and a four hole dorsal miniplate secured with 3.5 mm cortical screws. 4. Surface excision with machined conical reaming and fixation with a four hole dorsal miniplate secured with 3.5 mm cortical screws and no lag screw. 5. Planar surface excision and fixation with a single oblique 3.5 mm interfragmentary cortical lag screw. Testing was done on an Instron materials testing device loading the first MTP joint in dorsiflexion. Liquid metal strain gauges were placed over the joint and micromotion was detected with varying loads and cycles. The most stable technique was the combination of machined conical reaming and an oblique interfragmentary lag screw and dorsal plate. This was greater than two times stronger than an oblique lag screw alone. Dorsal plate alone and Kirschner wire fixation were the weakest techniques. First MTP fusion is a commonly performed procedure for the treatment of a variety of disorders of the first MTP joint. The most stable technique for obtaining fusion in this study was the combination of an oblique lag screw and a dorsal plate. This should lead to higher rates of arthrodesis.

The extracellular matrix architecture relating to myotendinous pattern formation in the distal part of the developing chick limb: an ultrastructural, histochemical and immunocytochemical analysis.

PubMed

Hurle, J M; Hinchliffe, J R; Ros, M A; Critchlow, M A; Genis-Galvez, J M

1989-07-01

In the later developmental stages (Hamburger and Hamilton, 25-34) the distal part of the chick leg possesses a distinctive extracellular matrix (ECM) architecture which relates to myotendinous patterning. There are two components: firstly, a system of dorsoventrally oriented fibrils which link the two ectodermal surfaces through the undifferentiated distal mesenchyme and secondly, a 'mesenchyme lamina' originates at the basement membrane distally, but proximally runs through the mesoderm, subjacent and parallel to the basement membrane. The 'mesenchyme lamina' appears to be a precursor of developing tendons and is spatially related to the distal tips of the myogenic blocks. As developing tendons form on the inner surface of the lamina at its proximal end, it becomes less distinct and disappears. Further dorsoventral fibrils run from the 'mesenchyme lamina' into the developing condensations and chondrogenic elements of the phalanges. The architecture of the ECM was revealed by silver and lectin staining (peanut and Ricinus communis agglutinins, PNA and RCA I), by immunocytochemistry (for fibronectin, tenascin, collagen type I) and by ultrastructural analysis. Both components stain with silver, PNA following neuraminidase digestion, RCA I, tenascin and collagen type I. However, the dorsoventral fibrils are positive for fibronectin and negative for PNA, while conversely the mesenchyme lamina is positive for PNA but much less so for fibronectin. Tenascin has been shown to be a specialized mesenchyme component of tendons and myotendinous junctions (Chiquet and Fambrough, 1984). Such a basement membrane forming a 'mesenchyme lamina' appears to be unique in epithelial-mesenchymal developing systems and points to an ectodermal role in tendon pattern formation within the mesenchyme. We discuss the possible role of mechanical force in converting the dorsoventral tenascin-positive fibrils into the localized pattern of tendon insertions into the proximal parts of the phalanges. Distally the dorsoventral fibrils may shape the digital plate by pulling together the two ectodermal surfaces. A similar ECM architecture is found in corresponding stages in the developing wing.

[New varieties of lateral metatarsophalangeal dislocations of the great toe].

PubMed

Bousselmame, N; Rachid, K; Lazrak, K; Galuia, F; Taobane, H; Moulay, I

2001-04-01

We report seven cases of traumatic dislocation of the great toe, detailing the anatomy, the mechanism of injury and the radiographic diagnosis. We propose an additional classification based on three hereto unreported cases. Between october 1994 and october 1997, we treated seven patients with traumatic dislocation of the first metatarso-phalangeal joint of the great toe. There were six men and one woman, mean age 35 years (range 24 - 44 years). Dislocation was caused by motor vehicle accidents in four cases and by falls in three. Diagnosis was made on anteroposterior, lateral and medial oblique radiographs. According to Jahss' classification, there was one type I and three type IIB dislocations. There was also one open lateral dislocation and two dorsomedial dislocations. Only these dorsomedial dislocations required open reduction, done via a dorsal approach. Mean follow-up was 17.5 months (range 9 - 24 months) in six cases. One patient was lost to follow-up. The outcome was good in six cases and poor in one (dorsomedial dislocation). Dislocation of the first metatarso-phalangeal joint of the great toe is an uncommon injury. In 1980, Jahss reported two cases and reviewed three others described in the literature. He proposed three types of dislocation based on the feasibility of closed reduction (type I, II and IIB). In 1991, Copeland and Kanat reported a unique case in which there was an association of IIA and IIB lesions. They proposed an addition to the classification (type IIC). In 1994, Garcia Mata et al. reported another case which had not been described by Jahss and proposed another addition. All dislocations reported to date have been sagittal dislocations. Pathological alteration of the collateral ligaments has not been previously reported. In our experience, we have seen one case of open lateral dislocation due, at surgical exploration, to medial ligament rupture and two cases of dorsomedial dislocation due, at surgical exploration, to lateral ligament rupture. We propose another additional classification with pure lateral dislocation (type III) and dorso-lateral dislocation (type IL or IIL+), which are related to the formerly described variants.

Pedal symphalangism in modern American and Japanese skeletons.

PubMed

Case, D T; Heilman, J

2005-01-01

Pedal symphalangism is a surprisingly common heritable trait of the human foot. In individuals exhibiting the trait, the joint between the intermediate and distal phalanges of one or more lateral toes never develops, resulting in toes with two phalanges rather than three. This study was undertaken to explore variation in the frequency of pedal symphalangism among groups with widely different geographic ancestry, and to consider the applicability of this trait to skeletal biological distance studies. A total of 460 Euro-American, 191 African-American and 99 Japanese skeletons were examined for presence of pedal symphalangism. The American individuals date to the first half of the 20th c, while the Japanese individuals date to the late 19th and early 20th c. Although the country of ancestry is unknown for most of the American individuals, the Euro-Americans appear to be largely northern European, with roots in Germany, Ireland and Scandinavia, while the African-Americans are primarily descendants of slaves with roots in west African countries such as Nigeria, Benin, Togo, Ghana and Sierra Leone. Frequencies of fifth toe pedal symphalangism were calculated and compared among all three samples and found to be significantly higher in modern Japanese (83.7%) than in either Euro-Americans (46.4%) or African-Americans (44.0%). The Euro- and African-American frequencies were statistically indistinguishable for symphalangism of the fifth toe. In the fourth toe, however, the opposite result was found. The African-American frequency (7.9%) was significantly higher than the Euro-American frequency (2.6%), while no difference was found between the African-Americans and Japanese (11.7%). Since fourth toe pedal symphalangism has never been observed in the absence of fifth toe involvement, some of the same genes are clearly involved in producing the trait in both toes. However, differences in the pattern of fourth and fifth toe expression among the three groups identified in this study suggest that additional genetic or developmental factors may play a role in expression of pedal symphalangism in each of the toes.

Increased Incidence and Severity of Postoperative Radiographic Hallux Valgus Interphalangeus With Surgical Correction of Hallux Valgus.

PubMed

Dixon, Alexis E; Lee, Lydia C; Charlton, Timothy P; Thordarson, David B

2015-08-01

A previous study has shown an increased radiographic prevalence and severity of hallux valgus interphalangeus (HVIP) after surgical correction of hallux valgus (HV) due to correction of pronation deformity. The purpose of this study was to evaluate the change in pre- and postoperative HVIP deformity with correction of HV with multiple radiographic parameters. A retrospective chart review identified all bunion surgeries performed at a single center from July 1, 2009, to September 30, 2012. Exclusion criteria included prior bony surgery to the first ray, inadequate films, nonadult bunion, Akin osteotomy, or surgical treatment other than bunion correction. Pre- and postoperative films were reviewed for 2 HV angular measurements and 5 HVIP measurements, which were compared. The angles measured were hallux valgus angle (HVA), first intermetatarsal angle (IMA), hallux interphalangeus angle (HIA), distal metatarsal articular angle (DMAA), proximal phalangeal articular angle (PPAA), proximal to distal phalangeal articular angle (PDPAA), and total distal deformity (TDD). Prevalence of HVIP was analyzed in pre- and postoperative radiographs. A 1-sided Student t test was used to compare continuous data, and a chi-square test was used to compare categorical data. Ninety-two feet in 82 patients were eligible. The average preoperative HV improved with surgery. Preoperative HVA improved from 27 to 11 degrees (P < .001). Preoperative IMA improved from 13.6 to 6.1 degrees (P < .001). HVIP worsened after surgery. Preoperative HIA increased from 7.2 to 13.2 degrees (P < .001). DMAA worsened from 7.3 to 9.2 degrees (P = .001). PPAA worsened from 3.2 to 6.2 degrees. PDPAA worsened from 6.7 to 8.2 degrees (P < .001). The TDD increased from 14.6 to 17.9 degrees (P < .001). The prevalence of HVIP pre- and postoperatively as defined by HIA increased from 26% to 79% (P < .001) and by PPAA from 12% to 46% (P < .001). Initial assessment of preoperative radiographs underestimated HVIP. Postoperative correction of the deformity revealed HVIP that was not obvious preoperatively. Level III, retrospective comparative series. © The Author(s) 2015.

[Symbrachydactyly].

PubMed

Samson, P; Mevio, G

2008-12-01

Symbrachydactyly is literally defined as a combination of short fingers with syndactyly. Blauth and Gekeler described four types of symbrachydactyly, ranging from simple shortness of middle phalanges to complete absence of digital rays. In type I (short finger) function is quite normal and syndactyly release is usually the only procedure needed. In type II (cleft hand), presence of a thumb and at least one ulnar finger allows pinch function. Surgical treatment, when needed, consists in separation of webbed fingers, resection of nonfunctional digital stumps, or finger translocation. In type III (monodactyly) all long fingers are absent. Pinch function can be created between the thumb and a toe transfer in ulnar location. Bone lengthening is an alternative procedure to create a pincer. Surgery is not always indicated in type IV (peromely) as function can only be restored if active motion is already present at wrist or carpometacarpal levels.

Acute hand and wrist injuries sustained during recreational mountain biking: a prospective study.

PubMed

Bush, Kevin; Meredith, Steve; Demsey, Daniel

2013-12-01

Recreational mountain biking continues to increase in popularity and is a significant source of traumatic injury, including injuries to the hand and wrist. A prospective survey of all hand and wrist injuries sustained while participating in recreational mountain biking presenting to the emergency department at the Municipality of Whistler and the District of Squamish was conducted over a 12-month consecutive period. An analysis of 765 unique emergency department visits with 1,079 distinct injuries was performed. Of these injuries, 511 were sustained to the upper limb. Injury to the metacarpal and metacarpal phalangeal joints was the most common hand injury (52) followed by proximal phalanx and proximal interphalangeal joint (20). Mountain biking is a frequent source of a variety of upper limb trauma, and preventative efforts are necessary to minimize the burden of these injuries.

Sudden multiple fractures in a patient with sarcoidosis in multiple organs.

PubMed

Sada, Mitsuru; Saraya, Takeshi; Ishii, Haruyuki; Goto, Hajime

2014-04-07

A 30-year-old man who incidentally fractured his right olecranon and other multiple phalanges was admitted to our hospital. He had a 2-year history of uveitis and bilateral hilar lymphadenopathy (BHL), and pulmonary sarcoidosis was diagnosed from transbronchial lung biopsy. Right elbow arthrodesis was performed, and biopsied specimens showed non-caseating epithelioid cell granuloma, suggesting osseous sarcoidosis. He was discharged uneventfully without further treatment, but BHL had progressed with the appearance of lung parenchymal lesions 3 months later. At that time, involvement of other organs was also noted on Gallium-67 scintigraphy, showing accumulations in BHL, axillary and inguinal lymph nodes, enlarged liver and spleen and subcutaneous areas. After initiation of steroid therapy, multiple organ involvement improved, and no further bone involvement has been recognised to date. Osseous sarcoidosis complicated by bone fracture is an extremely rare presentation, but should be considered in patients with sarcoidosis, especially when multiple organs are involved.

Stress fracture of the second proximal phalanx of the foot in teenage athletes: Unrecognized location of stress fracture.

PubMed

Yamaguchi, Satoshi; Taketomi, Shuji; Funakoshi, Yusei; Tsuchiya, Kan; Akagi, Ryuichiro; Kimura, Seiji; Sadamasu, Aya; Ohtori, Seiji

2017-10-01

Adolescent athletes are a high-risk population for stress fractures. We report four cases of stress fractures of the second proximal phalanx, which had not been previously diagnosed as the location of the stress fracture of the foot, in teenage athletes. All fractures were on the plantar side of the proximal phalangeal base, and the oblique images of the plain radiograph clearly depicted the fractures. Notably, three out of the four patients had histories of stress fracture of other locations. While three athletes with acute cases were able to make an early return to play with simple conservative management, the chronic case required surgical treatment for this rare injury. Although a rare injury, it is important that clinicians be aware of this type of stress fracture, as a timely diagnosis can avoid the need for surgical treatment and allow an early return to play.

Effect of foot massage to decrease physiological lower leg oedema in late pregnancy: a randomized controlled trial in Turkey.

PubMed

Coban, Ayden; Sirin, Ahsen

2010-10-01

This study aims to evaluate the effect of foot massage for decreasing physiological lower leg oedema in late pregnancy. Eighty pregnant women were randomly divided into two groups; study group had a 20 min foot massage daily for 5 days whereas the control group did not receive any intervention beyond standard prenatal care. The research was conducted between March and August 2007 in Manisa Province Health Ministry Central Primary Health Care Clinic 1, in Manisa, Western Turkey. Compared with the control group, women in the experimental group had a significantly smaller lower leg circumference (right and left, ankle, instep and metatarsal-phalanges joint) after 5 days of massage. The results obtained from our research show that foot massage was found to have a positive effect on decreasing normal physiological lower leg oedema in late pregnancy. © 2010 Blackwell Publishing Asia Pty Ltd.

DNA preservation in skeletal elements from the World Trade Center disaster: recommendations for mass fatality management.

PubMed

Mundorff, Amy Z; Bartelink, Eric J; Mar-Cash, Elaine

2009-07-01

The World Trade Center (WTC) victim identification effort highlights taphonomic influences on the degradation of DNA from victims of mass fatality incidents. This study uses a subset of the WTC-Human Remains Database to evaluate differential preservation of DNA by skeletal element. Recovery location, sex, and victim type (civilian, firefighter, or plane passenger) do not appear to influence DNA preservation. Results indicate that more intact elements, as well as elements encased in soft tissue, produced slightly higher identification rates than more fragmented remains. DNA identification rates by element type conform to previous findings, with higher rates generally found in denser, weight-bearing bones. However, smaller bones including patellae, metatarsals, and foot phalanges yielded rates comparable to both femora and tibiae. These elements can be easily sampled with a disposable scalpel, and thus reduce potential DNA contamination. These findings have implications for DNA sampling guidelines in future mass fatality incidents.

Cavernous sinus syndrome due to osteochondromatosis in a cat.

PubMed

Perazzi, Anna; Bernardini, Marco; Mandara, Maria T; De Benedictis, Giulia M; De Strobel, Francesca; Zotti, Alessandro

2013-12-01

A 1-year-old sexually intact male Korat cat was referred for ophthalmological consultation due to anisocoria. Mydriasis with external ophthalmoplegia and absence of pupillary light responses in the right eye and nasofacial hypalgesia were seen. Cavernous sinus syndrome (CSS) was suspected. Bilateral deformities of the jaw and phalangeal bones, severe spinal pain and abnormal conformation of the lumbar spine were also present. Radiographic examination revealed several mineralised masses in the appendicular and axial skeleton, indicative of multiple cartilaginous exostoses. For further investigation of the CSS-related neurological deficits, the cat underwent computed tomography (CT) examination of the skull. CT images revealed a non-vascularised, calcified, amorphous mass originating from the right lateral skull base and superimposing on the sella turcica. Based on the severity of diffuse lesions and owing to the clinical signs of extreme pain, the cat was euthanased. A diffuse skeletal and intracranial osteochondromatosis was diagnosed histologically.

Deletion at 12p in a Japanese child with brachydactyly overlaps the assignment locus of brachydactyly with hypertension in a Turkish family

DOE Office of Scientific and Technical Information (OSTI.GOV)

Baehring, S.; Toka, H.R.; Nitz, I.

1997-03-01

Positional cloning is occasionally facilitated by the identification of a chromosomal aberration. We are studying a Turkish family, first described by Bilginturan et al., who have a monogenic form of hypertension, and we have reason to believe that a chromosomal aberration in a Japanese child may facilitate our cloning of the responsible gene. The hypertension gene in our family is unique in that it causes, by as yet undefined mechanisms, increased peripheral vascular resistance. Pedigree analysis of the Turkish kindred allowed us to map the gene to 12p11-p12. The kindred has a second trait, brachyclactyly, which cosegregates with the hypertension.more » The brachyclactyly, which involves both hands and feet, features shortened metacarpals and phalanges, as well as cone-shaped epiphyses. 11 refs., 2 figs.« less

DOORS syndrome: phenotype, genotype and comparison with Coffin-Siris syndrome.

PubMed

Campeau, Philippe M; Hennekam, Raoul C

2014-09-01

DOORS syndrome (Deafness, Onychodystrophy, Osteodystrophy, mental Retardation, Seizures) is characterized mainly by sensorineural deafness, shortened terminal phalanges with small nails of hands and feet, intellectual deficiency, and seizures. Half of the patients with all clinical features have mutations in TBC1D24. We review here the manifestations of patients clinically diagnosed with DOORS syndrome. In this cohort of 32 families (36 patients) we detected 13 individuals from 10 families with TBC1D24 mutations. Subsequent whole exome sequencing in the cohort showed the same de novoSMARCB1 mutation (c.1130G>A), known to cause Coffin-Siris syndrome, in two patients. Distinguishing features include retinal anomalies, Dandy-Walker malformation, scoliosis, rocker bottom feet, respiratory difficulties and absence of seizures, and 2-oxoglutaric aciduria in the patients with the SMARCB1 mutation. We briefly discuss the heterogeneity of the DOORS syndrome phenotype and the differential diagnosis of this condition. © 2014 Wiley Periodicals, Inc.

The foot of Homo naledi.

PubMed

Harcourt-Smith, W E H; Throckmorton, Z; Congdon, K A; Zipfel, B; Deane, A S; Drapeau, M S M; Churchill, S E; Berger, L R; DeSilva, J M

2015-10-06

Modern humans are characterized by a highly specialized foot that reflects our obligate bipedalism. Our understanding of hominin foot evolution is, although, hindered by a paucity of well-associated remains. Here we describe the foot of Homo naledi from Dinaledi Chamber, South Africa, using 107 pedal elements, including one nearly-complete adult foot. The H. naledi foot is predominantly modern human-like in morphology and inferred function, with an adducted hallux, an elongated tarsus, and derived ankle and calcaneocuboid joints. In combination, these features indicate a foot well adapted for striding bipedalism. However, the H. naledi foot differs from modern humans in having more curved proximal pedal phalanges, and features suggestive of a reduced medial longitudinal arch. Within the context of primitive features found elsewhere in the skeleton, these findings suggest a unique locomotor repertoire for H. naledi, thus providing further evidence of locomotor diversity within both the hominin clade and the genus Homo.

The foot of Homo naledi

PubMed Central

Harcourt-Smith, W. E. H.; Throckmorton, Z.; Congdon, K. A.; Zipfel, B.; Deane, A. S.; Drapeau, M. S. M.; Churchill, S. E.; Berger, L. R.; DeSilva, J. M.

2015-01-01

Modern humans are characterized by a highly specialized foot that reflects our obligate bipedalism. Our understanding of hominin foot evolution is, although, hindered by a paucity of well-associated remains. Here we describe the foot of Homo naledi from Dinaledi Chamber, South Africa, using 107 pedal elements, including one nearly-complete adult foot. The H. naledi foot is predominantly modern human-like in morphology and inferred function, with an adducted hallux, an elongated tarsus, and derived ankle and calcaneocuboid joints. In combination, these features indicate a foot well adapted for striding bipedalism. However, the H. naledi foot differs from modern humans in having more curved proximal pedal phalanges, and features suggestive of a reduced medial longitudinal arch. Within the context of primitive features found elsewhere in the skeleton, these findings suggest a unique locomotor repertoire for H. naledi, thus providing further evidence of locomotor diversity within both the hominin clade and the genus Homo. PMID:26439101

Bone Lengthening in the Pediatric Upper Extremity.

PubMed

Farr, Sebastian; Mindler, Gabriel; Ganger, Rudolf; Girsch, Werner

2016-09-07

➤Bone lengthening has been used successfully for several congenital and acquired conditions in the pediatric clavicle, humerus, radius, ulna, and phalanges.➤Common indications for bone lengthening include achondroplasia, radial longitudinal deficiency, multiple hereditary exostosis, brachymetacarpia, symbrachydactyly, and posttraumatic and postinfectious growth arrest.➤Most authors prefer distraction rates of <1 mm/day for each bone in the upper extremity except the humerus, which can safely be lengthened by 1 mm/day.➤Most authors define success by the amount of radiographic bone lengthening, joint motion after lengthening, and subjective patient satisfaction rather than validated patient-related outcome measures.➤Bone lengthening of the upper extremity is associated with a high complication rate, with complications including pin-track infections, fixation device failure, nerve lesions, nonunion, fracture of regenerate bone, and joint dislocations. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.

Human Grasp Assist Device With Exoskeleton

NASA Technical Reports Server (NTRS)

Bergelin, Bryan J (Inventor); Ihrke, Chris A. (Inventor); Davis, Donald R. (Inventor); Linn, Douglas Martin (Inventor); Bridgwater, Lyndon B. J. (Inventor)

2014-01-01

A grasp assist system includes a glove, actuator assembly, and controller. The glove includes a digit, i.e., a finger or thumb, and a force sensor. The sensor measures a grasping force applied to an object by an operator wearing the glove. Phalange rings are positioned with respect to the digit. A flexible tendon is connected at one end to one of the rings and is routed through the remaining rings. An exoskeleton positioned with respect to the digit includes hinged interconnecting members each connected to a corresponding ring, and/or a single piece of slotted material. The actuator assembly is connected to another end of the tendon. The controller calculates a tensile force in response to the measured grasping force, and commands the tensile force from the actuator assembly to thereby pull on the tendon. The exoskeleton offloads some of the tensile force from the operator's finger to the glove.

Freely Chosen Index Finger Tapping Frequency Is Increased in Repeated Bouts of Tapping.

PubMed

Hansen, Ernst Albin; Ebbesen, Brian Duborg; Dalsgaard, Ane; Mora-Jensen, Mark Holten; Rasmussen, Jakob

2015-01-01

Healthy individuals (n = 40) performed index finger tapping at freely chosen frequency during repeated bouts and before and after near-maximal muscle action consisting of 3 intense flexions of the index finger metacarpal phalangeal joint. One experiment showed, unexpectedly, that a bout of tapping increased the tapping frequency in the subsequent bout. Thus, a cumulating increase of 8.2 ± 5.4% (p < .001) occurred across 4 bouts, which were all separated by 10 min rest periods. Follow-up experiments revealed that tapping frequency was still increased in consecutive bouts when rest periods were extended to 20 min. Besides, near-maximal muscle activation, followed by 5 min rest, did not affect the tapping frequency. In conclusion, freely chosen tapping frequency was increased in repeated bouts of tapping, which were separated by 10-20 min rest periods. The observed phenomenon is suggested to be termed repeated bout rate enhancement.

Screening method based on walking plantar impulse for detecting musculoskeletal senescence and injury.

PubMed

Fan, Yifang; Fan, Yubo; Li, Zhiyu; Newman, Tony; Lv, Changsheng; Zhou, Yi

2013-01-01

No consensus has been reached on how musculoskeletal system injuries or aging can be explained by a walking plantar impulse. We standardize the plantar impulse by defining a principal axis of plantar impulse. Based upon this standardized plantar impulse, two indexes are presented: plantar pressure record time series and plantar-impulse distribution along the principal axis of plantar impulse. These indexes are applied to analyze the plantar impulse collected by plantar pressure plates from three sources: Achilles tendon ruptures; elderly people (ages 62-71); and young people (ages 19-23). Our findings reveal that plantar impulse distribution curves for Achilles tendon ruptures change irregularly with subjects' walking speed changes. When comparing distribution curves of the young, we see a significant difference in the elderly subjects' phalanges plantar pressure record time series. This verifies our hypothesis that a plantar impulse can function as a means to assess and evaluate musculoskeletal system injuries and aging.

Basilar membrane and reticular lamina motion in a multi-scale finite element model of the mouse cochlea

NASA Astrophysics Data System (ADS)

Soons, Joris; Dirckx, Joris; Steele, Charles; Puria, Sunil

2015-12-01

A multi-scale finite element (FE) model of the mouse cochlea, based on its anatomy and material properties is presented. The important feature in the model is a lattice of 400 Y-shaped structures in the longitudinal direction, each formed by Deiters cells, phalangeal processes and outer hair cells (OHC). OHC somatic motility is modeled by an expansion force proportional to the shear on the stereocilia, which in turn is proportional to the pressure difference between the scala vestibule and scala tympani. Basilar membrane (BM) and reticular lamina (RL) velocity compare qualitatively very well with recent in vivo measurements in guinea pig [2]. Compared to the BM, the RL is shown to have higher amplification and a shift to higher frequencies. This comes naturally from the realistic Y-shaped cell organization without tectorial membrane tuning.

Tendon injuries of the hand

PubMed Central

Schöffl, Volker; Heid, Andreas; Küpper, Thomas

2012-01-01

Tendon injuries are the second most common injuries of the hand and therefore an important topic in trauma and orthopedic patients. Most injuries are open injuries to the flexor or extensor tendons, but less frequent injuries, e.g., damage to the functional system tendon sheath and pulley or dull avulsions, also need to be considered. After clinical examination, ultrasound and magnetic resonance imaging have proved to be important diagnostic tools. Tendon injuries mostly require surgical repair, dull avulsions of the distal phalanges extensor tendon can receive conservative therapy. Injuries of the flexor tendon sheath or single pulley injuries are treated conservatively and multiple pulley injuries receive surgical repair. In the postoperative course of flexor tendon injuries, the principle of early passive movement is important to trigger an “intrinsic” tendon healing to guarantee a good outcome. Many substances were evaluated to see if they improved tendon healing; however, little evidence was found. Nevertheless, hyaluronic acid may improve intrinsic tendon healing. PMID:22720265

Photoacoustic tomography of the human finger: towards the assessment of inflammatory joint diseases

NASA Astrophysics Data System (ADS)

van Es, P.; Biswas, S. K.; Bernelot Moens, H. J.; Steenbergen, W.; Manohar, S.

2015-03-01

Inflammatory arthritis is often manifested in finger joints. The growth of new or withdrawal of old blood vessels can be a sensitive marker for these diseases. Photoacoustic (PA) imaging has great potential in this respect since it allows the sensitive and highly resolved visualization of blood. We systematically investigated PA imaging of finger vasculature in healthy volunteers using a newly developed PA tomographic system. We present the PA results which show excellent detail of the vasculature. Vessels with diameters ranging between 100 μm and 1.5 mm are visible along with details of the skin, including the epidermis and the subpapillary plexus. The focus of all the studies is at the proximal and distal interphalangeal joints, and in the context of ultimately visualizing the inflamed synovial membrane in patients. This work is important in laying the foundation for detailed research into PA imaging of the phalangeal vasculature in patients suffering from rheumatoid arthritis.

Human Grasp Assist Device Soft Goods

NASA Technical Reports Server (NTRS)

Ihrke, Chris A. (Inventor); Davis, Donald R. (Inventor); Bergelin, Bryan (Inventor); Bridgwater, Lyndon B. J. (Inventor); Bibby, Heather (Inventor); Schroeder, Judy (Inventor); Linn, Douglas Martin (Inventor); Erkkila, Craig (Inventor)

2015-01-01

A grasp assist system includes a glove and a flexible sleeve. The glove includes a digit such as a finger or thumb, a force sensor configured to measure a grasping force applied to an object by an operator wearing the glove, and adjustable phalange rings positioned with respect to the digit. A saddle is positioned with respect to the finger. A flexible tendon is looped at one end around the saddle. A conduit contains the tendon. A conduit anchor secured within a palm of the glove receives the conduit. The sleeve has pockets containing an actuator assembly connected to another end of the tendon and a controller. The controller is in communication with the force sensor, and calculates a tensile force in response to the measured grasping force. The controller commands the tensile force from the actuator assembly to tension the tendon and thereby move the finger.

The Effect of Landing Surface on the Plantar Kinetics of Chinese Paratroopers Using Half-Squat Landing

PubMed Central

Li, Yi; Wu, Ji; Zheng, Chao; Huang, Rong Rong; Na, Yuhong; Yang, Fan; Wang, Zengshun; Wu, Di

2013-01-01

The objective of the study was to determine the effect of landing surface on plantar kinetics during a half-squat landing. Twenty male elite paratroopers with formal parachute landing training and over 2 years of parachute jumping experience were recruited. The subjects wore parachuting boots in which pressure sensing insoles were placed. Each subject was instructed to jump off a platform with a height of 60 cm, and land on either a hard or soft surface in a half-squat posture. Outcome measures were maximal plantar pressure, time to maximal plantar pressure (T-MPP), and pressure-time integral (PTI) upon landing on 10 plantar regions. Compared to a soft surface, hard surface produced higher maximal plantar pressure in the 1st to 4th metatarsal and mid-foot regions, but lower maximal plantar pressure in the 5th metatarsal region. Shorter T- MPP was found during hard surface landing in the 1st and 2nd metatarsal and medial rear foot. Landing on a hard surface landing resulted in a lower PTI than a soft surface in the 1stphalangeal region. For Chinese paratroopers, specific foot prosthesis should be designed to protect the1st to 4thmetatarsal region for hard surface landing, and the 1stphalangeal and 5thmetatarsal region for soft surface landing. Key Points Understanding plantar kinetics during the half-squat landing used by Chinese paratroopers can assist in the design of protective footwear. Compared to landing on a soft surface, a hard surface produced higher maximal plantar pressure in the 1st to 4th metatarsal and mid-foot regions, but lower maximal plantar pressure in the 5th metatarsal region. A shorter time to maximal plantar pressure was found during a hard surface landing in the 1st and 2nd metatarsals and medial rear foot. Landing on a hard surface resulted in a lower pressure-time integral than landing on a soft surface in the 1st phalangeal region. For Chinese paratroopers, specific foot prosthesis should be designed to protect the 1st to 4th metatarsal region for a hard surface landing, and the 1st phalangeal and 5th metatarsal region for a soft surface landing. PMID:24149145

Tuberculous Dactylitis with Concomitant Thyroid Involvement: A Rare Presentation of Childhood Tuberculosis.

PubMed

Qamar, Sobia; Naz, Farrah; Naz, Samia; Ejaz, Iftikhar

2017-03-01

Extrapulmonary tuberculosis rarely presents as thyroid involvement along with other manifestations, and poses a diagnostic challenge on account of paucibacillary nature of disease. In general, the diagnosis of tuberculosis is based on epidemiological risk factors, clinical features, imaging studies, in addition to a positive skin testing or Interferon Gamma Release Assay (IGRA). A 14-year boy presented with history of fever and weight loss for one year. On examination, he had painful swelling of fingers and toes along with a painless thyroid nodule and squint. Hand X-ray showed lytic-sclerotic lesions in phalanges. MRI of brian showed multiple ring enhancing lesions and radionuclide thyroid scan showed multinodular goitre. Histology showed epithelioid cell granulomas (thyroid and bone) and tuberculomas of brain confirmed tuberculosis. He responded well to four-drug anti-tuberculous therapy and his fever, squint, thyroid nodule, and dactylitis disappeared. Tuberculosis of thyroid, a rare phenomenon, can be diagnosed and treated well; if clinical index of suspicion is kept high, particularly in tuberculosis prevalent areas.

Structural Integration and Control of Peerless Human-like Prosthetic Hand

NASA Astrophysics Data System (ADS)

Dave, Ankit; Muthu, P.; Karthikraj, V.; Latha, S.

2018-04-01

Limb damage can create severe disturbance in movement and operative abilities wherein the prosthetic rehabilitation has the potential to replace function and enhance the quality of life. This paper presents a humanlike prosthetic hand using such unique design concept of hand model using artificial bones, ligaments, and tendons controlled using Arduino. Amongst various platforms available, Arduino is known for its adaptability, adoration and low cost. The design of prosthetic hand has a unique structure with all carpal, metacarpal, and phalanges which are bones of the hand. These bones are attached to each other following the pattern of human hand using the polymeric rubber as a functioning ligament. Furthermore, this structure of finger is driven by tendons attached to all fingers and passes through the ligaments working as pulley resulting in more degrees of freedom. The motor can twitch the tendons to achieve the action of fingers. Thus the servos, controlled by an Arduino, are used to regulate the movement mechanism of the prosthetic hand.

A new species of Pseudopaludicola Miranda-Ribeiro (Leiuperinae: Leptodactylidae: Anura) from the Cerrado of Southeastern Brazil.

PubMed

De Andrade, Felipe Silva; De Carvalho, Thiago Ribeiro

2013-01-22

A new species of Pseudopaludicola is described from the Cerrado of southeastern Brazil. Pseudopaludicola facureae sp. nov. is diagnosed from the P. pusilla species group by the absence of either T-shaped terminal phalanges or toe tips expanded, and distinguished from almost all recognized taxa currently assigned to Pseudopaludicola (except P. canga, P. giarettai, and P. hyleaustralis) by possessing a non-pulsed advertisement call. However, the advertisement call of the new species consists of the emission of well-defined call series, whereas the advertisement call of P. giarettai is long (117-187 ms) and with an isolated emission pattern; respecting to P. canga, the new species emits very long notes series (up to 53 notes/advertisement call), compared to the short call series of P. canga (up to 9 notes/advertisement call); considering P. hyleaustralis, the new species has a shorter note duration (15-35 ms), higher note rate per minute (480-1860), and higher dominant frequency (4076-5108).

A Plutonium-Contaminated Wound, 1985, USA

DOE Office of Scientific and Technical Information (OSTI.GOV)

Doran M. Christensen, DO, REAC /TS Associate Director and Staff Physician Eugene H. Carbaugh, CHP, Staff Scientist, Internal Dosimetry Manager, Pacific Northwest National Laboratory, Richland, Washington

2012-02-02

A hand injury occurred at a U.S. facility in 1985 involving a pointed shaft (similar to a meat thermometer) that a worker was using to remove scrap solid plutonium from a plastic bottle. The worker punctured his right index finger on the palm side at the metacarpal-phalangeal joint. The wound was not through-and- through, although it was deep. The puncture wound resulted in deposition of ~48 kBq of alpha activity from the weapons-grade plutonium mixture with a nominal 12 to 1 Pu-alpha to {sup 241}Am-alpha ratio. This case clearly showed that DTPA was very effective for decorporation of plutonium andmore » americium. The case is a model for management of wounds contaminated with transuranics: (1) a team approach for dealing with all of the issues surrounding the incident, including the psychological, (2) early surgical intervention for foreign-body removal, (3) wound irrigation with DTPA solution, and (4) early and prolonged DTPA administration based upon bioassay and in vivo dosimetry.« less

A non-contact technique for measuring eccrine sweat gland activity using passive thermal imaging.

PubMed

Krzywicki, Alan T; Berntson, Gary G; O'Kane, Barbara L

2014-10-01

An approach for monitoring eccrine sweat gland activity using high resolution Mid-Wave Infrared (MWIR) imaging (3-5 μm wave band) is described. This technique is non-contact, passive, and provides high temporal and spatial resolution. Pore activity was monitored on the face and on the volar surfaces of the distal and medial phalanges of the index and middle fingers while participants performed a series of six deep inhalation and exhalation exercises. Two metrics called the Pore Activation Index (PAI) and Pore Count (PC) were defined as size-weighted and unweighted measures of active sweat gland counts respectively. PAI transient responses on the finger tips were found to be positively correlated to Skin Conductance Responses (SCRs). PAI responses were also observed on the face, although the finger sites appeared to be more responsive. Results indicate that thermal imaging of the pore response may provide a useful, non-contact, correlate measure for electrodermal responses recorded from related sites. Published by Elsevier B.V.

Perinatal Case of Fatal Simpson-Golabi-Behmel Syndrome with Hyperplasia of Seminiferous Tubules.

PubMed

Zimmermann, Nives; Stanek, Jerzy

2017-06-10

BACKGROUND Simpson-Golabi-Behmel syndrome (SGBS) is a rare X-linked recessive syndrome characterized by fetal overgrowth. CASE REPORT We present a case of a male infant with SGBS. Abnormal prenatal ultrasound (including congenital diaphragmatic hernia) prompted microarray testing of amniotic fluid cells, which showed deletion on chromosome Xq26.2 affecting the glypican-3 gene consistent with SGBS type I. The infant died six hours after birth and at autopsy showed features of SGBS, including macrosomia, organomegaly, diaphragmatic hernia with consequent pulmonary hypoplasia, cleft palate, large tongue with a midline groove, a supernumerary nipple, Meckel's diverticulum, and abnormal phalanges. Additionally, we observed features that have previously not been described in SGBS, including testes with hyperplastic seminiferous tubules and Mullerian remnants, and placenta with incipient fetal thrombotic vasculopathy. CONCLUSIONS While most patients with SGBS type I survive into childhood or even adulthood, the severe course in our patient was ascribed to pulmonary hypoplasia secondary to the bilateral diaphragmatic hernia.

Two novel POC1A mutations in the primordial dwarfism, SOFT syndrome: Clinical homogeneity but also unreported malformations.

PubMed

Barraza-García, Jimena; Iván Rivera-Pedroza, Carlos; Salamanca, Luis; Belinchón, Alberta; López-González, Vanesa; Sentchordi-Montané, Lucía; del Pozo, Ángela; Santos-Simarro, Fernando; Campos-Barros, Ángel; Lapunzina, Pablo; Guillén-Navarro, Encarna; González-Casado, Isabel; García-Miñaur, Sixto; Heath, Karen E

2016-01-01

Primordial dwarfism encompasses rare conditions characterized by severe intrauterine growth retardation and growth deficiency throughout life. Recently, three POC1A mutations have been reported in six families with the primordial dwarfism, SOFT syndrome (Short stature, Onychodysplasia, Facial dysmorphism, and hypoTrichosis). Using a custom-designed Next-generation sequencing skeletal dysplasia panel, we have identified two novel homozygous POC1A mutations in two individuals with primordial dwarfism. The severe growth retardation and the facial profiles are strikingly similar between our patients and those described previously. However, one of our patients was diagnosed with severe foramen magnum stenosis and subglottic tracheal stenosis, malformations not previously associated with this syndrome. Our findings confirm that POC1A mutations cause SOFT syndrome and that mutations in this gene should be considered in patients with severe pre- and postnatal short stature, symmetric shortening of long bones, triangular facies, sparse hair and short, thickened distal phalanges. © 2015 Wiley Periodicals, Inc.

Inferring Ancient Technology and Practices of the Elite Maya Kingship Through the Application of Materials Engineering Characterization Modalities

NASA Astrophysics Data System (ADS)

Cheung, Kristina Alyssa

This project focuses on the characterization of materials from burial offerings and painted decoration in a royal Maya tomb at El Zotz, Guatemala, and their association with mortuary rituals. Archaeological findings included vessels, jade masks, organic materials (wood, cord, and textiles), specular hematite cubes, shells with powdered cinnabar, green (malachite) painted stucco assumed to have decorated the wooden bier where the king was resting, and caches of lip-to-lip Aguila Orange bowls containing human phalanges. This paper describes findings from non-invasive and non-destructive analytical techniques including XRF, VPSEM-EDS, and XRD, emphasizing the potential of these combined technologies in the identification of organic and inorganic markers to infer burial customs. The nature and location of the findings, the evidence of pigment coloration on the bones employing hematite and cinnabar, and the indication of exposure of the bones to high temperatures suggest highly complex, even protracted mortuary practices of Maya elite.

Treatment alternatives of congenital hand differences with thumb hypoplasia involvement.

PubMed

Papadogeorgou, Ellada V; Soucacos, Panayotis N

2008-01-01

Congenital thumb hypoplasia is a complex and heterogeneous congenital difference that is detrimental to hand function. Apart from its' classic form, which is now considered to be part of radial dysplasia, it can occur as part of other congenital anomalies including, syndactyly, symbrachydactyly, atypical cleft hand, bifid thumb, triphalangeal thumb, mirror hand, constriction band syndrome, as well as generalized anomalies and syndromes. Management is aimed primarily at restoring basic hand function, specifically, power grasp and precision pinch, and secondarily to improve cosmoses, which inevitably is going to be impaired. Several treatment alternatives have been proposed to manage the specific disabling condition and include, 1st web space reconstruction and opponensplasty, pollicization, toe-to-hand transfer, distraction lengthening, free toe phalangeal transfer or the use of allograft, stabilization of the metacarpophalangeal joint, and surgery of "spare parts." The purpose of this study is to evaluate the various alternatives available today and propose an algorithm applicable for the appropriate management of thumb deficiency, based on their specific characteristics. Copyright 2008 Wiley-Liss, Inc. Microsurgery, 2008.

A gigantic new dinosaur from Argentina and the evolution of the sauropod hind foot.

PubMed

González Riga, Bernardo J; Lamanna, Matthew C; Ortiz David, Leonardo D; Calvo, Jorge O; Coria, Juan P

2016-01-18

Titanosauria is an exceptionally diverse, globally-distributed clade of sauropod dinosaurs that includes the largest known land animals. Knowledge of titanosaurian pedal structure is critical to understanding the stance and locomotion of these enormous herbivores and, by extension, gigantic terrestrial vertebrates as a whole. However, completely preserved pedes are extremely rare among Titanosauria, especially as regards the truly giant members of the group. Here we describe Notocolossus gonzalezparejasi gen. et sp. nov. from the Upper Cretaceous of Mendoza Province, Argentina. With a powerfully-constructed humerus 1.76 m in length, Notocolossus is one of the largest known dinosaurs. Furthermore, the complete pes of the new taxon exhibits a strikingly compact, homogeneous metatarsus--seemingly adapted for bearing extraordinary weight--and truncated unguals, morphologies that are otherwise unknown in Sauropoda. The pes underwent a near-progressive reduction in the number of phalanges along the line to derived titanosaurs, eventually resulting in the reduced hind foot of these sauropods.

The extreme insular adaptation of Garganornis ballmanni Meijer, 2014: a giant Anseriformes of the Neogene of the Mediterranean Basin

PubMed Central

Meijer, Hanneke J. M.; Rossi, Maria Adelaide; Göhlich, Ursula B.

2017-01-01

New skeletal elements of the recently described endemic giant anseriform Garganornis ballmanni Meijer, 2014 are presented, coming from the type-area of the Gargano and from Scontrone, southern and central Italy, respectively. The new remains represent the first bird remains found at Scontrone so far, and another shared element between these two localities, both part of the Apulia-Abruzzi Palaeobioprovince. The presence of a very reduced carpometacarpus confirms its flightlessness, only previously supposed on the basis of the very large size, while the morphologies of tarsometatarsus and posterior phalanges clearly indicate the adaptation of G. ballmanni to a terrestrial, non-aquatic, lifestyle. Its very large body size is similar to that observed in different, heavily modified, insular waterfowl and has been normally interpreted as the response to the absence of terrestrial predators and a protection from the aerial ones. The presence of a carpal knob in the proximal carpometacarpus also indicates a fighting behaviour for this large terrestrial bird species. PMID:28280574

Design and control of a hand exoskeleton for use in extravehicular activities

NASA Technical Reports Server (NTRS)

Shields, B.; Peterson, S.; Strauss, A.; Main, J.

1993-01-01

To counter problems inherent in extravehicular activities (EVA) and complex space operations, an exoskeleton, a unique adaptive structure, has been designed. The exoskeleton fits on the hand and powers the proximal and middle phalanges of the index finger, the middle finger, and the combined ring and little finger. A kinematic analysis of the exoskeleton joints was performed using the loop-closure method. This analysis determined the angular displacement and velocity relationships of the exoskeleton joints. This information was used to determine the output power of the exoskeleton. Three small DC motors (one for each finger) are used to power the exoskeleton. The motors are mounted on the forearm. Power is transferred to the exoskeleton using lead screws. The control system for the exoskeleton measures the contact force between the operator and the exoskeleton. This information is used as the input to drive the actuation system. The control system allows the motor to rotate in both directions so that the operator may close or open the exoskeleton.

The fickle finger of fate

PubMed Central

de la Fuente, Luis; Helms, Jill A.

2005-01-01

In this issue of the JCI, Niedermaier and colleagues demonstrate that a chromosomal inversion in mice results in dysregulation of Sonic hedgehog (Shh), such that Shh is ectopically expressed in a skeletogenic domain typically occupied by Indian hedgehog (Ihh). This molecular reversal eliminates phalangeal joint spaces, and consequently, Short digits (Dsh) heterozygotes (Dsh/+) have brachydactyly (shortened digits). Ihh is normally downregulated in regions that will become the joint space, but in Dsh/+ mice, Shh bypasses this regulatory control and persists; accordingly, cells maintain their chondrogenic fate and the developed digits are shorter than normal. The significance of these data extends far beyond the field of skeletal biology: they hint at the very real possibility that the endogenous Shh regulatory region contains a repressor designed to segregate the activity of Shh from Ihh. The existence of such a repressor provides a window into the distant past, revealing that Shh and Ihh must once have shared responsibilities in establishing tissue boundaries and orchestrating vertebrate tissue morphogenesis. PMID:15841172

Multiple congenital brachymetatarsia. A one-stage combined shortening and lengthening procedure without iliac bone graft.

PubMed

Kim, J S; Baek, G H; Chung, M S; Yoon, P W

2004-09-01

We performed nine metatarsal and three proximal phalangeal lengthenings in five patients with congenital brachymetatarsia of the first and one or two other metatarsal bones, by a one-stage combined shortening and lengthening procedure using intercalcary autogenous bone grafts from adjacent shortened metatarsal bones. Instead of the isolated lengthening of the first and the other metatarsal bones, we shortened the adjacent normal metatarsal and used the excised bone to lengthen the short toes, except for the great toe, to restore the normal parabola. One skin incision was used. All the operations were performed bilaterally and the patients were followed up for a mean period of 69.5 months (29 to 107). They all regained a nearly normal parabola and were satisfied with the cosmetic results. Our technique is straightforward and produces good cosmetic results. Satisfactory, bony union is achieved, morbidity is low, and no additional surgery is required for the removal of metal implants.

Attenuated sensing of SHH by Ptch1 underlies evolution of bovine limbs.

PubMed

Lopez-Rios, Javier; Duchesne, Amandine; Speziale, Dario; Andrey, Guillaume; Peterson, Kevin A; Germann, Philipp; Unal, Erkan; Liu, Jing; Floriot, Sandrine; Barbey, Sarah; Gallard, Yves; Müller-Gerbl, Magdalena; Courtney, Andrew D; Klopp, Christophe; Rodriguez, Sabrina; Ivanek, Robert; Beisel, Christian; Wicking, Carol; Iber, Dagmar; Robert, Benoit; McMahon, Andrew P; Duboule, Denis; Zeller, Rolf

2014-07-03

The large spectrum of limb morphologies reflects the wide evolutionary diversification of the basic pentadactyl pattern in tetrapods. In even-toed ungulates (artiodactyls, including cattle), limbs are adapted for running as a consequence of progressive reduction of their distal skeleton to symmetrical and elongated middle digits with hoofed phalanges. Here we analyse bovine embryos to establish that polarized gene expression is progressively lost during limb development in comparison to the mouse. Notably, the transcriptional upregulation of the Ptch1 gene, which encodes a Sonic hedgehog (SHH) receptor, is disrupted specifically in the bovine limb bud mesenchyme. This is due to evolutionary alteration of a Ptch1 cis-regulatory module, which no longer responds to graded SHH signalling during bovine handplate development. Our study provides a molecular explanation for the loss of digit asymmetry in bovine limb buds and suggests that modifications affecting the Ptch1 cis-regulatory landscape have contributed to evolutionary diversification of artiodactyl limbs.

Bite Injuries to the Hand - Review of the Literature

PubMed Central

Raval, Pradyumna; Khan, Wasim; Haddad, Behrooz; Mahapatra, Anant Narayan

2014-01-01

Patients presenting to the emergency department with bite injuries to the hand sustain them through a number of causes including domesticated as well as stray animal bites, and human bites commonly sustained as a result of violence. The nature of the injuries sustained can be very deceptive. A small tooth mark on the exterior can be a fulminant infection in the tissues deeper down. Tendon injuries, fractures of the metacarpals and phalanges and management of the wound are critical issues faced by a surgeon in dealing with such patients. Similarly the less common bite injuries to the hand, often with disastrous and sometimes fatal complications, do also present to the emergency department. A high incidence of suspicion is needed in dealing with these injuries effectively. In our article we discuss the common as well as uncommon causes of bite injuries to the hand and their management. In addition to reviewing the literature to ascertain the management of such injuries, we also discuss interesting and rare case reports. PMID:25097675

Effect of feeding graded doses of Citrinin on clinical and teratology in female Wistar rats.

PubMed

Singh, N D; Sharma, A K; Patil, R D; Rahman, S; Leishangthem, G D; Kumar, M

2014-02-01

Citrinin is the one of the well-known mycotoxins, which is possibly spread all over the world. The graded doses of citrinin (1, 3 and 5 ppm CIT in feed) in female Wistar rats 10 weeks prior to mating, during mating and during organogenesis resulted in resorptions and post implantation losses, decreased fetal body weights and crown-rump lengths in fetuses of all groups. Various developmental anomalies recorded in fetuses of treated rats included gross (wrist drop, curled tail, stretched forelimb, subcutaneous haematoma), skeletal (incomplete ossification of skull bones, incomplete fusion of vertebral bodies, complete and partial agenesis of sternaebrae, metacarpals, metatarsals and phalanges, fused ribs and swing out ribs) and visceral (internal and external hydrocephalus, cerebellar hypoplasia, microphthalmia, roundening of heart, contracted kidneys, dilated renal pelvis and cryptorchid testes). The results suggest that CIT has adverse effects on fetal development which may be due to the longer bioavailability of citrinin in the animals.

Screening Method Based on Walking Plantar Impulse for Detecting Musculoskeletal Senescence and Injury

PubMed Central

Fan, Yifang; Fan, Yubo; Li, Zhiyu; Newman, Tony; Lv, Changsheng; Zhou, Yi

2013-01-01

No consensus has been reached on how musculoskeletal system injuries or aging can be explained by a walking plantar impulse. We standardize the plantar impulse by defining a principal axis of plantar impulse. Based upon this standardized plantar impulse, two indexes are presented: plantar pressure record time series and plantar-impulse distribution along the principal axis of plantar impulse. These indexes are applied to analyze the plantar impulse collected by plantar pressure plates from three sources: Achilles tendon ruptures; elderly people (ages 62–71); and young people (ages 19–23). Our findings reveal that plantar impulse distribution curves for Achilles tendon ruptures change irregularly with subjects’ walking speed changes. When comparing distribution curves of the young, we see a significant difference in the elderly subjects’ phalanges plantar pressure record time series. This verifies our hypothesis that a plantar impulse can function as a means to assess and evaluate musculoskeletal system injuries and aging. PMID:24386288

The choice of procedure following thumb amputation.

PubMed

Lister, G

1985-05-01

The attributes that make the thumb unique are position, stability, strength, length, motion, sensibility, and appearance. Of these qualities, the first four must be present to an acceptable extent for function to approach normality, while the latter three are very desirable but not essential. Reconstructive alternatives following amputation can be considered in four broad groups: where the length is acceptable but the covering is poor; subtotal amputation, where length is equivocal; total amputation with the basal joint preserved; and total amputation with the basal joint destroyed. In the first group, soft-tissue cover can be improved by local flaps with or without a neurovascular pedicle or by microvascular free pulp transfer. In the second group, metacarpal lengthening by distraction, with or without phalangization, may give adequate length. In total amputations, one may choose osteoplastic reconstruction, pollicization, or toe-to-hand transfer. Which solution is selected depends on the level of the amputation, the presence and nature of injuries to other digits, occupational and social factors, and the availability of tissues.

Modelling three-dimensional cochlear micromechanics within the guinea pig organ of Corti

NASA Astrophysics Data System (ADS)

Ni, Guangjian; Elliott, Stephen J.

2018-05-01

The active amplification process in the mammalian cochlea depends on a complex interaction between cells within the organ of Corti. A three-dimensional (3D) model was developed using the finite element method based on anatomy for the apical end in the guinea pig cochlea, which is comprised of 3D discrete hair cells, 3D continuous membranes and fluid. The basilar membrane, tectorial membrane and the reticular lamina are modelled with orthotropic materials. The Y-shape structures formed by the outer hair cell (OHC), the Deiters' cell and Deiters' cell phalangeal process are also included to account for the structural longitudinal coupling. The motion within the organ of Corti was first simulated in response to a pressure difference loading on the basilar membrane, in order to calculate the passive vibration pattern. Then, the outer hair cells somatic electromotility was implemented by applying a voltage across the OHC walls to investigate its contribution to membranes motion.

A gigantic new dinosaur from Argentina and the evolution of the sauropod hind foot

PubMed Central

González Riga, Bernardo J.; Lamanna, Matthew C.; Ortiz David, Leonardo D.; Calvo, Jorge O.; Coria, Juan P.

2016-01-01

Titanosauria is an exceptionally diverse, globally-distributed clade of sauropod dinosaurs that includes the largest known land animals. Knowledge of titanosaurian pedal structure is critical to understanding the stance and locomotion of these enormous herbivores and, by extension, gigantic terrestrial vertebrates as a whole. However, completely preserved pedes are extremely rare among Titanosauria, especially as regards the truly giant members of the group. Here we describe Notocolossus gonzalezparejasi gen. et sp. nov. from the Upper Cretaceous of Mendoza Province, Argentina. With a powerfully-constructed humerus 1.76 m in length, Notocolossus is one of the largest known dinosaurs. Furthermore, the complete pes of the new taxon exhibits a strikingly compact, homogeneous metatarsus—seemingly adapted for bearing extraordinary weight—and truncated unguals, morphologies that are otherwise unknown in Sauropoda. The pes underwent a near-progressive reduction in the number of phalanges along the line to derived titanosaurs, eventually resulting in the reduced hind foot of these sauropods. PMID:26777391

Rehabilitation for bilateral amputation of fingers

USGS Publications Warehouse

Stapanian, Martin A.; Stapanian, Adrienne M.P.; Staley, Keith E.

2010-01-01

We describe reconstructive surgeries, therapy, prostheses, and adaptations for a patient who experienced bilateral amputation of all five fingers of both hands through the proximal phalanges in January 1992. The patient made considerable progress in the use of his hands in the 10 mo after amputation, including nearly a 120% increase in the active range of flexion of metacarpophalangeal joints. In late 1992 and early 1993, the patient had "on-top plasty" surgeries, in which the index finger remnants were transferred onto the thumb stumps, performed on both hands. The increased web space and functional pinch resulting from these procedures made many tasks much easier. The patient and occupational therapists set challenging goals at all times. Moreover, the patient was actively involved in the design and fabrication of all prostheses and adaptations or he developed them himself. Although he was discharged from occupational therapy in 1997, the patient continues to actively find new solutions for prehension and grip strength 18 yr after amputation.

A COCHLEAR MODEL USING THE TIME-AVERAGED LAGRANGIAN AND THE PUSH-PULL MECHANISM IN THE ORGAN OF CORTI.

PubMed

Yoon, Yongjin; Puria, Sunil; Steele, Charles R

2009-09-05

In our previous work, the basilar membrane velocity V(BM) for a gerbil cochlea was calculated and compared with physiological measurements. The calculated V(BM) showed excessive phase excursion and, in the active case, a best-frequency place shift of approximately two fifths of an octave higher. Here we introduce a refined model that uses the time-averaged Lagrangian for the conservative system to resolve the phase excursion issues. To improve the overestimated best-frequency place found in the previous feed-forward active model, we implement in the new model a push-pull mechanism from the outer hair cells and phalangeal process. Using this new model, the V(BM) for the gerbil cochlea was calculated and compared with animal measurements, The results show excellent agreement for mapping the location of the maximum response to frequency, while the agreement for the response at a fixed point as a function of frequency is excellent for the amplitude and good for the phase.

A COCHLEAR MODEL USING THE TIME-AVERAGED LAGRANGIAN AND THE PUSH-PULL MECHANISM IN THE ORGAN OF CORTI

PubMed Central

YOON, YONGJIN; PURIA, SUNIL; STEELE, CHARLES R.

2010-01-01

In our previous work, the basilar membrane velocity VBM for a gerbil cochlea was calculated and compared with physiological measurements. The calculated VBM showed excessive phase excursion and, in the active case, a best-frequency place shift of approximately two fifths of an octave higher. Here we introduce a refined model that uses the time-averaged Lagrangian for the conservative system to resolve the phase excursion issues. To improve the overestimated best-frequency place found in the previous feed-forward active model, we implement in the new model a push-pull mechanism from the outer hair cells and phalangeal process. Using this new model, the VBM for the gerbil cochlea was calculated and compared with animal measurements, The results show excellent agreement for mapping the location of the maximum response to frequency, while the agreement for the response at a fixed point as a function of frequency is excellent for the amplitude and good for the phase. PMID:20485540

Body size and scaling of the hands and feet of prosimian primates.

PubMed

Lemelin, Pierre; Jungers, William L

2007-06-01

The hands and feet of primates fulfill a variety of biological roles linked with food acquisition and positional behavior. Current explanations of shape differences in cheiridial morphology among prosimians are closely tied to body size differences. Although numerous studies have examined the relationships between body mass and limb morphology in prosimians, no scaling analysis has specifically considered hand and foot dimensions and intrinsic proportions. In this study, we present such an analysis for a sample of 270 skeletal specimens distributed over eight prosimian families. The degree of association between size and shape was assessed using nonparametric correlational techniques, while the relationship between each ray element length and body mass (from published data and a body mass surrogate) was tested for allometric scaling. Since tarsiers and strepsirrhines encompass many taxa of varying degrees of phylogenetic relatedness, effective degrees of freedom were calculated, and comparisons between families were performed to partially address the problem of statistical nonindependence and "phylogenetic inertia." Correlational analyses indicate negative allometry between relative phalangeal length (as reflected by phalangeal indices) and body mass, except for the pollex and hallux. Thus, as size increases, there is a significant decrease in the relative length of the digits when considering all prosimian taxa sampled. Regression analyses show that while the digital portion of the rays scales isometrically with body mass, the palmar/plantar portion of the rays often scales with positive allometry. Some but not all of these broadly interspecific allometric patterns remain statistically significant when effective degrees of freedom are taken into account. As is often the case in interspecific scaling, comparisons within families show different scaling trends in the cheiridia than those seen across families (i.e., lorisids, indriids, and lemurids exhibit rather different allometries). The interspecific pattern of positive allometry that appears to best characterize the metapodials of prosimians, especially those of the foot, parallels differences found in the morphology of the volar skin. Indeed, relatively longer metapodials appear to covary with flatter and more coalesced volar pads, which in turn slightly improve frictional force for animals that are at a comparative disadvantage while climbing because of their larger mass. Despite the essentially isometric relationship found between digit length and body mass across prosimians, examination of the residual variation reveals that tarsiers and Daubentonia possess, relative to their body sizes, remarkably long fingers. Such marked departures between body size and finger length observed in these particular primates are closely linked with specialized modes of prey acquisition and manipulation involving the hands.

First metatarsophalangeal joint replacement with modular three-component press-fit implant. Preliminary report.

PubMed

Kolodziej, L; Bohatyrewicz, A; Zietek, P

2013-01-01

The aim of this retrospective study was to assess functional and radiographic results of the first metatarsophalangeal joint replacement with use of unconstrained, modular, three components, porous titanium and hydroxyapatite coated, press-fit METIS® prosthesis. According to author's knowledge, results of that type of prosthesis have never been published before. 25 prosthesis were implanted in 24 patients between February 2009 and May 2011. American Orthopaedic Foot and Ankle Society Hallux Metatarsophalangeal Interphalangeal scoring system (AOFAS-HMI) was used to assess functional results. Patients were also asked if they would undergo procedure again or recommend it to other people. Weight bearing radiographs ware made at final follow up and analyzed for presence of osteolysis and radiolucencies. In 8 patients total joint replacement was introduced as a salvage after failure of previous surgery like Keller resection arthroplasty, failed arthrodesis, avascular necrosis and postoperative arthritis. In 11 patients the reason for prosthetic replacement were hallux rigidus, in 4 cases rheumatoid arthritis and gout in one patient. In two patients additional procedures like Akin phalangeal osteotomy and in one case fifth metatarsal osteotomy, was performed. There were 20 females and 4 males in presented group. The mean age at the operation was 56 years. The average follow up period was 18 months (from 12 to 36 months). The median postoperative value of AOFAS-HMI scores was 88 points (from 75 to 95 points). First metatarsophalangeal joint motion (dorsiflexion plus plantarflexion) was classified according to AOFAS-HMI ranges as: moderately restricted (between 30 to 70 degrees) in 19 patients 80% (20 prosthesis) and severely restricted (less then 30 degrees) in 5 patients (20%). 15 (64%) patients were completely satisfied, 5 (20%) reported moderate satisfaction and (16%) 4 were totally disappointed and would not undergo this procedure again. A limited hallux dorsiflexion was the main dissatisfaction reason. Partial radiolucent line was seen in one patient (4%). Authors noticed two serious complications. In one patient, with rheumatoid arthritis, deep infection occurred 12 months after prosthesis implantation. In second case phalangeal implant was revised due to misalignment. METIS® metatarsophalangeal joint replacement allows alleviate of pain relating to hallux rigidus and partial restoration of joint movement, even in patients after failures of primary metatarsophalangeal joint surgery. AOFAS-HMI results are better than previously reported in the literature in assessment of the first metatarsophalangeal joint replacement. Radiographic results imply satisfactory bone ingrowth into the cementless implants.

Skeletal development in the African elephant and ossification timing in placental mammals

PubMed Central

Hautier, Lionel; Stansfield, Fiona J.; Allen, W. R. Twink; Asher, Robert J.

2012-01-01

We provide here unique data on elephant skeletal ontogeny. We focus on the sequence of cranial and post-cranial ossification events during growth in the African elephant (Loxodonta africana). Previous analyses on ossification sequences in mammals have focused on monotremes, marsupials, boreoeutherian and xenarthran placentals. Here, we add data on ossification sequences in an afrotherian. We use two different methods to quantify sequence heterochrony: the sequence method and event-paring/Parsimov. Compared with other placentals, elephants show late ossifications of the basicranium, manual and pedal phalanges, and early ossifications of the ischium and metacarpals. Moreover, ossification in elephants starts very early and progresses rapidly. Specifically, the elephant exhibits the same percentage of bones showing an ossification centre at the end of the first third of its gestation period as the mouse and hamster have close to birth. Elephants show a number of features of their ossification patterns that differ from those of other placental mammals. The pattern of the initiation of the ossification evident in the African elephant underscores a possible correlation between the timing of ossification onset and gestation time throughout mammals. PMID:22298853

The morphological basis of hallucal orientation in extant birds.

PubMed

Middleton, K M

2001-10-01

The perching foot of living birds is commonly characterized by a reversed or opposable digit I (hallux). Primitively, the hallux of nonavian theropod dinosaurs was unreversed and lay parallel to digits II-IV. Among basal birds, a unique digital innovation evolved in which the hallux opposes digits II-IV. This digital configuration is critical for grasping and perching. I studied skeletons of modern birds with a range of hallucal designs, from unreversed (anteromedially directed) to fully reversed (posteriorly directed). Two primary correlates of hallucal orientation were revealed. First, the fossa into which metatarsal I articulates is oriented slightly more posteriorly on the tarsometatarsus, rotating the digit as a unit. Second, metatarsal I exhibits a distinctive torsion of its distal shaft relative to its proximal articulation with the tarsometatarsus, reorienting the distal condyles and phalanges of digit I. Herein, I present a method that facilitates the re-evaluation of hallucal orientation in fossil avians based on morphology alone. This method also avoids potential misinterpretations of hallucal orientation in fossil birds that could result from preserved appearance alone. Copyright 2001 Wiley-Liss, Inc.

Sliding Window-Based Region of Interest Extraction for Finger Vein Images

PubMed Central

Yang, Lu; Yang, Gongping; Yin, Yilong; Xiao, Rongyang

2013-01-01

Region of Interest (ROI) extraction is a crucial step in an automatic finger vein recognition system. The aim of ROI extraction is to decide which part of the image is suitable for finger vein feature extraction. This paper proposes a finger vein ROI extraction method which is robust to finger displacement and rotation. First, we determine the middle line of the finger, which will be used to correct the image skew. Then, a sliding window is used to detect the phalangeal joints and further to ascertain the height of ROI. Last, for the corrective image with certain height, we will obtain the ROI by using the internal tangents of finger edges as the left and right boundary. The experimental results show that the proposed method can extract ROI more accurately and effectively compared with other methods, and thus improve the performance of finger vein identification system. Besides, to acquire the high quality finger vein image during the capture process, we propose eight criteria for finger vein capture from different aspects and these criteria should be helpful to some extent for finger vein capture. PMID:23507824

A new species of Pseudopaludicola Miranda-Ribeiro, 1926 (Anura: Leptodactylidae: Leiuperinae) from northwestern state of São Paulo, Brazil.

PubMed

Pansonato, André; Mudrek, Jessica Rhaiza; Veiga-Menoncello, Ana Cristina Prado; Rossa-Feres, Denise De Cerqueira; Martins, Itamar Alves; Strüssmann, Christine

2014-09-15

A new species of Pseudopaludicola is described from human-altered areas originally covered by Semideciduous Forest in northwestern state of São Paulo, southeastern Brazil. Morphologically, the new species differs from four species belonging to the P. pusilla group by the absence of either T-shaped terminal phalanges or toe tips expanded, and from all other congeners except P. canga and P. facureae by possessing an areolate vocal sac, with dark reticulation. The higher duration (300-700 ms) of each single, pulsed note (9-36 nonconcatenated pulses) that compose the call in the new species distinguishes it from all other 14 species of Pseudopaludicola with calls already described (10-290 ms). Absence of harmonics also differ the advertisement call of the new species from the call of its sister species P. facureae, even though these two species presented unexpected low genetic distances. Although we could not identify any single morphological character distinguishing the new species from P. facureae, a PCA and DFA performed using 12 morphometric variables evidenced significant size differences between these two species. 

Quantitative photoplethysmography: Lambert-Beer law or inverse function incorporating light scatter.

PubMed

Cejnar, M; Kobler, H; Hunyor, S N

1993-03-01

Finger blood volume is commonly determined from measurement of infra-red (IR) light transmittance using the Lambert-Beer law of light absorption derived for use in non-scattering media, even when such transmission involves light scatter around the phalangeal bone. Simultaneous IR transmittance and finger volume were measured over the full dynamic range of vascular volumes in seven subjects and outcomes compared with data fitted according to the Lambert-Beer exponential function and an inverse function derived for light attenuation by scattering materials. Curves were fitted by the least-squares method and goodness of fit was compared using standard errors of estimate (SEE). The inverse function gave a better data fit in six of the subjects: mean SEE 1.9 (SD 0.7, range 0.7-2.8) and 4.6 (2.2, 2.0-8.0) respectively (p < 0.02, paired t-test). Thus, when relating IR transmittance to blood volume, as occurs in the finger during measurements of arterial compliance, an inverse function derived from a model of light attenuation by scattering media gives more accurate results than the traditional exponential fit.

Radiographic anatomy of the foot and ankle—part 4: the metatarsals.

PubMed

Christman, Robert A

2015-01-01

The normal radiographic anatomy of the foot and ankle, aside from my previous work, has been addressed only superficially or sparingly in the medical literature. This project correlates the detailed radiographic anatomy of the entire adult foot and ankle (two-dimensional) to osteology (three-dimensional). Each bone's position was determined after meticulous examination and correlation to an articulated skeleton relative to the image receptor and direction of the x-ray beam, with correlation to the radiograph for confirmation. Images of each foot and distal leg bone ("front" and "back" perspectives) are presented alongside a corresponding radiographic image for comparison. The normal gross and radiographic anatomy is correlated and described for each radiographic positioning technique. Foundational knowledge is provided that future researchers can use as a baseline ("normal") and that students and practitioners can use for comparison when interpreting radiographs and distinguishing abnormal findings. The results of the original project, owing to its broad scope, have been divided into five parts: the lower leg, the greater tarsus, the lesser tarsus, the metatarsals (the focus of this article), and the phalanges.

A boy with developmental delay, malformations, and evidence of a connective tissue disorder: possibly a new type of cutis laxa.

PubMed

Armstrong, Linlea; Jimenez, Carmencita; Hunter, Alasdair G W

2003-05-15

We report a 7.5-year-old boy with loose translucent skin, aortic dilatation, hyperextensible veins, recurrent respiratory problems, pectus excavatum, arthralgias, lax joints, mild epiphyseal dysplasia, and umbilical and inguinal hernias. He also has developmental delay, progressive bilateral sensorineural hearing loss, an unusual facial appearance, terminal digit hypoplasia with unusual radiographic changes in some of the phalanges, glandular hypospadias, shawl scrotum, and undescended testes. Biochemical investigations, including electrophoresis of Types 1 and 3 procollagens and collagens, and quantification of serum copper and ceruloplasmin, are normal. Relative to age-matched control patients the electron micrographs of the boy's dermis show elastin fibers to be decreased in number, and abnormal in appearance, with a low matrix to microfibril ratio. The organ distribution of abnormalities and the nature of the findings suggest a connective tissue disorder. We contrast and compare this boy's phenotype to those of the classic connective tissue disorders. We conclude that he has cutis laxa with features that distinguish him from previously described types of cutis laxa. Copyright 2003 Wiley-Liss, Inc.

Radiographic anatomy of the foot and ankle-part 2: the greater tarsus.

PubMed

Christman, Robert A

2014-01-01

Normal radiographic anatomy of the foot and ankle, aside from my previous work, has been addressed only superficially or sparingly in the medical literature. This project correlates detailed radiographic anatomy of the entire adult foot and ankle (two-dimensional) to osteology (three-dimensional). Each bone's position was determined after meticulous examination and correlation to an articulated skeleton relative to the image receptor and direction of the x-ray beam, with correlation to the radiograph for confirmation. Images of each foot and distal leg bone ("front" and "back" perspectives) are presented alongside a corresponding radiographic image for comparison. The normal gross and radiographic anatomy is correlated and described for each radiographic positioning technique. Foundational knowledge is provided that future researchers can use as a baseline ("normal") and that students and practitioners can use for comparison when interpreting radiographs and distinguishing abnormal findings. The results of the original project, owing to its broad scope, have been divided into five parts: the lower leg, the greater tarsus (the focus of this article), the lesser tarsus, the metatarsals, and the phalanges.

All Madelung deformities are not endocrine

PubMed Central

Kumar, Ajay; Rai, Gopal K.; Akhtar, Javed; Phillip, Rajeev; Gutch, Manish; Arya, T. V. S.

2013-01-01

Madelung deformity is a rare inherited disorder associated with endocrine disorders like Turner's syndrome, pseudohypoparathyroidism, but can be seen with short stature homeobox deficiency conditions such as Leri-Weill dyschondrosteosis (LWD) and Langers mesomelic dysplasia. It has also been reported following trauma to the distal radius epiphysis neoplasia mucopolysaccharidosis (MPS) and achondroplasia. Madelung deformity is an abnormality of distal radial epiphysis where in progressive ulnar and volar tilt of the articular surface occurring in association with distal subluxation of ulna. A 13-year-old girl was referred to us for evaluation of bilateral deformity of wrist and short stature. There was ulnar deviation and dorsal tilt of bilateral hands without history of pain to the joint trauma and family history of similar illness. On X-ray, wrist showed malformed distal radial epiphysis with dorsal and ulnar shift and with increased length of phalanges suggestive of Madelung deformity. X-ray spine was normal. Ultrasound abdomen showed normal uterus and ovary and her follicle stimulating hormone. Luteinizing hormone was normal and so was urine MPS screening. Based on the above points the diagnosis of LWD was made. PMID:24251169

All Madelung deformities are not endocrine.

PubMed

Kumar, Ajay; Rai, Gopal K; Akhtar, Javed; Phillip, Rajeev; Gutch, Manish; Arya, T V S

2013-10-01

Madelung deformity is a rare inherited disorder associated with endocrine disorders like Turner's syndrome, pseudohypoparathyroidism, but can be seen with short stature homeobox deficiency conditions such as Leri-Weill dyschondrosteosis (LWD) and Langers mesomelic dysplasia. It has also been reported following trauma to the distal radius epiphysis neoplasia mucopolysaccharidosis (MPS) and achondroplasia. Madelung deformity is an abnormality of distal radial epiphysis where in progressive ulnar and volar tilt of the articular surface occurring in association with distal subluxation of ulna. A 13-year-old girl was referred to us for evaluation of bilateral deformity of wrist and short stature. There was ulnar deviation and dorsal tilt of bilateral hands without history of pain to the joint trauma and family history of similar illness. On X-ray, wrist showed malformed distal radial epiphysis with dorsal and ulnar shift and with increased length of phalanges suggestive of Madelung deformity. X-ray spine was normal. Ultrasound abdomen showed normal uterus and ovary and her follicle stimulating hormone. Luteinizing hormone was normal and so was urine MPS screening. Based on the above points the diagnosis of LWD was made.

Non-vascularized free toe phalanx transfers in congenital hand deformities--the Great Ormond Street experience.

PubMed

Cavallo, A V; Smith, P J; Morley, S; Morsi, A W

2003-12-01

Many options of varying complexity are available for the management of congenital short digits resulting from aphalangia in symbrachydactyly and constriction ring syndrome. We have used non-vascularized free toe phalanx transfers for these children when a vascularized toe transfer has been contraindicated. We describe our technique and experience with 22 children who underwent a total of 64 transfers of the proximal (35) or middle (29) toe phalanges (average 3 per child). The mean age at initial surgery was 15 months, and the mean follow-up was 5 years. Duration of time until epiphyseal closure could not be determined accurately, but total digital elongation averaged 6mm. Complications of this technique include joint instability, premature epiphyseal closure and, in one patient, infection and graft loss. Donor site deformity was determined according to measured growth deficit and toe function. This technique is a simple option for digital elongation and, if performed in the appropriate age group in short fingered and monodactylous subtypes of symbrachydactyly, has the potential to allow growth and function with minimal donor site deficit.

Monochromatic computed microtomography using laboratory and synchrotron sources and X-ray fluorescence analysis for comprehensive analysis of structural changes in bones.

PubMed

Buzmakov, Alexey; Chukalina, Marina; Nikolaev, Dmitry; Gulimova, Victoriya; Saveliev, Sergey; Tereschenko, Elena; Seregin, Alexey; Senin, Roman; Zolotov, Denis; Prun, Victor; Shaefer, Gerald; Asadchikov, Victor

2015-06-01

A combination of X-ray tomography at different wavelengths and X-ray fluorescence analysis was applied in the study of two types of bone tissue changes: prolonged presence in microgravity conditions and age-related bone growth. The proximal tail vertebrae of geckos were selected for investigation because they do not bear the supporting load in locomotion, which allows them to be considered as an independent indicator of gravitational influence. For the vertebrae of geckos no significant differences were revealed in the elemental composition of the flight samples and the synchronous control samples. In addition, the gecko bone tissue samples from the jaw apparatus, spine and shoulder girdle were measured. The dynamics of structural changes in the bone tissue growth was studied using samples of a human fetal hand. The hands of human fetuses of 11-15 weeks were studied. Autonomous zones of calcium accumulation were found not only in individual fingers but in each of the investigated phalanges. The results obtained are discussed.

Monochromatic computed microtomography using laboratory and synchrotron sources and X-ray fluorescence analysis for comprehensive analysis of structural changes in bones1

PubMed Central

Buzmakov, Alexey; Chukalina, Marina; Nikolaev, Dmitry; Gulimova, Victoriya; Saveliev, Sergey; Tereschenko, Elena; Seregin, Alexey; Senin, Roman; Zolotov, Denis; Prun, Victor; Shaefer, Gerald; Asadchikov, Victor

2015-01-01

A combination of X-ray tomography at different wavelengths and X-ray fluorescence analysis was applied in the study of two types of bone tissue changes: prolonged presence in microgravity conditions and age-related bone growth. The proximal tail vertebrae of geckos were selected for investigation because they do not bear the supporting load in locomotion, which allows them to be considered as an independent indicator of gravitational influence. For the vertebrae of geckos no significant differences were revealed in the elemental composition of the flight samples and the synchronous control samples. In addition, the gecko bone tissue samples from the jaw apparatus, spine and shoulder girdle were measured. The dynamics of structural changes in the bone tissue growth was studied using samples of a human fetal hand. The hands of human fetuses of 11–15 weeks were studied. Autonomous zones of calcium accumulation were found not only in individual fingers but in each of the investigated phalanges. The results obtained are discussed. PMID:26089762

Multiple fractures and impaired bone metabolism in Wolfram syndrome: a case report.

PubMed

Catalano, Antonino; Bellone, Federica; Cicala, Giuseppe; Giandalia, Annalisa; Morabito, Nunziata; Cucinotta, Domenico; Russo, Giuseppina Tiziana

2017-01-01

Wolfram Syndrome (WS) is a rare and lethal disease characterized by optic atrophy, diabetes mellitus, diabetes insipidus, and hearing loss. To date, osteoporotic related fractures have not been reported in affected patients. Here, we describe the case of a man affected by WS complicated by several bone fragility fractures. A 50-year-old Caucasian man was hospitalized because of tibia and fibula fractures. His clinical features included diabetes mellitus, diabetes insipidus, optic atrophy and deafness that were consistent with an unrecognized WS diagnosis, which was confirmed by the identification of a specific mutation in gene WFS1 encoding wolframin. Bone mineral density by phalangeal quantitative ultrasound demonstrated severe osteoporosis, with high serum levels of surrogate markers of bone turn-over. Previously unidentified rib fractures were also detected. To the best of our knowledge, this is the first report of osteoporotic related fractures in a patient affected by WS. Although no effective treatments are currently available to delay the progression of the disease, this case report suggests to evaluate fracture risk in the diagnostic work-up of WS.

Open globe injury with an interesting intra-ocular foreign body

PubMed Central

Gill, Ekjyot; Shulman, Matthew; Schechet, Sid; Grumbine, Lawson

2017-01-01

Introduction: Cases of penetrating ocular trauma due to osseous material are limited, so reported incidents are valuable in determining outcomes and proper treatment courses. Case description: We report a case of an open globe injury of the left eye with an intraocular foreign body occurring after a firework exploded in the hand of a 22-year-old man. The patient presented with light perception vision in the injured eye with a full-thickness limbal laceration and dense hyphema obscuring fundoscopy. CT scan revealed a hyperdense foreign body juxtaposed to the lens. Immediate surgical intervention to repair the globe rupture revealed a defect in the anterior capsule and small, white objects in the posterior chamber that were promptly removed. Pathologic investigation determined these fragments to be cortical bone likely from the patient’s phalanges. Results and discussion: There was no evidence of endophthalmitis or keratitis from time of injury to the five-month follow-up, suggesting that the risk of infection may be low and therefore it may be reasonable to manage these injuries with a period of observation. PMID:28706770

Radiographic anatomy of juvenile bovine limbs.

PubMed

Hoey, S E; Biedrzycki, A H; Livesey, M J; Drees, R

2016-11-26

Juvenile bovine patients who present with clinical signs of lameness are commonly evaluated using radiographic techniques both within a hospital setting and in a farm environment. The radiographic development of the juvenile bovine skeleton is currently poorly documented. In this study, the limbs of four heifer calves were sequentially radiographed to assess development of the juvenile bovine appendicular skeleton in the first 12 months of life. Images were acquired at three weeks, three months, six months, nine months and one year of age. The normal radiographic anatomy of the fore limbs and hindlimbs and the changes over the first 12 months are described. The majority of physes remain open throughout this period, with the exception of the proximal physes of the proximal and middle phalanges, the proximal radial physis, and the proximal humeral physis which close radiographically between 9 months and 12 months of age, and fusion of the fourth and central tarsal bones occurs between 9 months and 12 months of age. The results of this study may aid in differentiating normal and abnormal anatomy in the juvenile bovine limb. British Veterinary Association.

The multi zinc-finger protein Trps1 acts as a regulator of histone deacetylation during mitosis.

PubMed

Wuelling, Manuela; Pasdziernik, Markus; Moll, Carina N; Thiesen, Andrea M; Schneider, Sabine; Johannes, Christian; Vortkamp, Andrea

2013-07-15

TRPS1, the gene mutated in human "Tricho-Rhino-Phalangeal syndrome," encodes a multi zinc-finger nuclear regulator of chondrocyte proliferation and differentiation. Here, we have identified a new function of Trps1 in controlling mitotic progression in chondrocytes. Loss of Trps1 in mice leads to an increased proportion of cells arrested in mitosis and, subsequently, to chromosome segregation defects. Searching for the molecular basis of the defect, we found that Trps1 acts as regulator of histone deacetylation. Trps1 interacts with two histone deacetylases, Hdac1 and Hdac4, thereby increasing their activity. Loss of Trps1 results in histone H3 hyperacetylation, which is maintained during mitosis. Consequently, chromatin condensation and binding of HP1 is impaired, and Trps1-deficient chondrocytes accumulate in prometaphase. Overexpression of Hdac4 rescues the mitotic defect of Trps1-deficient chondrocytes, identifying Trps1 as an important regulator of chromatin deacetylation during mitosis in chondrocytes. Our data provide the first evidence that the control of mitosis can be linked to the regulation of chondrocyte differentiation by epigenetic consequences of altered Hdac activity.

Design of a robotic device for assessment and rehabilitation of hand sensory function.

PubMed

Lambercy, Olivier; Robles, Alejandro Juárez; Kim, Yeongmi; Gassert, Roger

2011-01-01

This paper presents the design and implementation of the Robotic Sensory Trainer, a robotic interface for assessment and therapy of hand sensory function. The device can provide three types of well controlled stimuli: (i) angular displacement at the metacarpophalangeal (MCP) joint using a remote-center-of-motion double-parallelogram structure, (ii) vibration stimuli at the fingertip, proximal phalange and palm, and (iii) pressure at the fingertip, while recording position, interaction force and feedback from the user over a touch screen. These stimuli offer a novel platform to investigate sensory perception in healthy subjects and patients with sensory impairments, with the potential to assess deficits and actively train detection of specific sensory cues in a standardized manner. A preliminary study with eight healthy subjects demonstrates the feasibility of using the Robotic Sensory Trainer to assess the sensory perception threshold in MCP angular position. An average just noticeable difference (JND) in the MCP joint angle of 2.46° (14.47%) was found, which is in agreement with previous perception studies. © 2011 IEEE

Studies on reproductive toxicity of iloprost in rats, rabbits and monkeys.

PubMed

Battenfeld, R; Schuh, W; Schöbel, C

1995-08-01

A reproduction toxicological test program was performed with the carbaprostacyclin derivative iloprost, an analogue to the endogenous prostacyclin PGI2, in order to detect possible effects on fertility and reproductive performance, on preimplantational, embryonal and fetal development, on delivery as well as on lactation and postpartum development. While in humans iloprost is administered as an i.v. infusion for 6 h/day, it was administered i.v. to rats, rabbits and monkeys by continuous infusion with a subcutaneously implanted pump. No influence on mating or reproductive parameters was found after treatment of male or female rats during the premating phase up to day 7 post coitum (p.c.). Embryonal and fetal development were not remarkably impaired in rabbits or monkeys after treatment throughout the period of organogenesis. The only remarkable observations in the embryotoxicity and peri-/postnatal studies in the rat were defects on the digits (reductions of phalangeal structures) in single individuals. These malformations were interpreted as resulting from a compound-related hypotonia with subsequent change in the regional blood flow and the consequence of temporary impairments of placental blood supply leading to hypoxia in the affected structures.

Convergent Evidence of Eagle Talons Used by Late Neanderthals in Europe: A Further Assessment on Symbolism

PubMed Central

Romandini, Matteo; Peresani, Marco; Laroulandie, Véronique; Metz, Laure; Pastoors, Andreas; Vaquero, Manuel; Slimak, Ludovic

2014-01-01

To contribute to have a better understanding of the symbolic or not use of certain items by Neanderthals, this work presents new evidence of the deliberate removal of raptor claws occurred in Mediterranean Europe during the recent phases of the Mousterian. Rio Secco Cave in the north-east of Italy and Mandrin Cave in the Middle Rhône valley have recently produced two golden eagle pedal phalanges from contexts not younger than 49.1–48.0 ky cal BP at Rio Secco and dated around 50.0 ky cal BP at Mandrin. The bones show cut-marks located on the proximal end ascribable to the cutting of the tendons and the incision of the cortical organic tissues. Also supported by an experimental removal of large raptor claws, our reconstruction explains that the deliberate detachment occurred without damaging the claw, in a way comparable at a general level with other Mousterian contexts across Europe. After excluding that these specimens met the nutritional requirements for human subsistence, we discuss the possible implications these findings perform in our current knowledge of the European Middle Palaeolithic context. PMID:25010346

Optical HMI with biomechanical energy harvesters integrated in textile supports

NASA Astrophysics Data System (ADS)

De Pasquale, G.; Kim, SG; De Pasquale, D.

2015-12-01

This paper reports the design, prototyping and experimental validation of a human-machine interface (HMI), named GoldFinger, integrated into a glove with energy harvesting from fingers motion. The device is addressed to medical applications, design tools, virtual reality field and to industrial applications where the interaction with machines is restricted by safety procedures. The HMI prototype includes four piezoelectric transducers applied to the fingers backside at PIP (proximal inter-phalangeal) joints, electric wires embedded in the fabric connecting the transducers, aluminum case for the electronics, wearable switch made with conductive fabrics to turn the communication channel on and off, and a LED. The electronic circuit used to manage the power and to control the light emitter includes a diodes bridge, leveling capacitors, storage battery and switch made by conductive fabric. The communication with the machine is managed by dedicated software, which includes the user interface, the optical tracking, and the continuous updating of the machine microcontroller. The energetic benefit of energy harvester on the battery lifetime is inversely proportional to the activation time of the optical emitter. In most applications, the optical port is active for 1 to 5% of the time, corresponding to battery lifetime increasing between about 14% and 70%.

Object-oriented approach to the automatic segmentation of bones from pediatric hand radiographs

NASA Astrophysics Data System (ADS)

Shim, Hyeonjoon; Liu, Brent J.; Taira, Ricky K.; Hall, Theodore R.

1997-04-01

The purpose of this paper is to develop a robust and accurate method that automatically segments phalangeal and epiphyseal bones from digital pediatric hand radiographs exhibiting various stages of growth. The development of this system draws principles from object-oriented design, model- guided analysis, and feedback control. A system architecture called 'the object segmentation machine' was implemented incorporating these design philosophies. The system is aided by a knowledge base where all model contours and other information such as age, race, and sex, are stored. These models include object structure models, shape models, 1-D wrist profiles, and gray level histogram models. Shape analysis is performed first by using an arc-length orientation transform to break down a given contour into elementary segments and curves. Then an interpretation tree is used as an inference engine to map known model contour segments to data contour segments obtained from the transform. Spatial and anatomical relationships among contour segments work as constraints from shape model. These constraints aid in generating a list of candidate matches. The candidate match with the highest confidence is chosen to be the current intermediate result. Verification of intermediate results are perform by a feedback control loop.

Bone disease in primary hyperparathyroidism

PubMed Central

Bandeira, Francisco; Cusano, Natalie E.; Silva, Barbara C.; Cassibba, Sara; Almeida, Clarissa Beatriz; Machado, Vanessa Caroline Costa; Bilezikian, John P.

2015-01-01

Bone disease in severe primary hyperparathyroidism (PHPT) is described classically as osteitis fibrosa cystica (OFC). Bone pain, skeletal deformities and pathological fractures are features of OFC. Bone mineral density is usually extremely low in OFC, but it is reversible after surgical cure. The signs and symptoms of severe bone disease include bone pain, pathologic fractures, proximal muscle weakness with hyperreflexia. Bone involvement is typically characterized as salt-and-pepper appearance in the skull, bone erosions and bone resorption of the phalanges, brown tumors and cysts. In the radiography, diffuse demineralization is observed, along with pathological fractures, particularly in the long bones of the extremities. In severe, symptomatic PHPT, marked elevation of the serum calcium and PTH concentrations are seen and renal involvement is manifested by nephrolithiasis and nephrocalcinosis. A new technology, recently approved for clinical use in the United States and Europe, is likely to become more widely available because it is an adaptation of the lumbar spine DXA image. Trabecular bone score (TBS) is a gray-level textural analysis that provides an indirect index of trabecular microarchitecture. Newer technologies, such as high-resolution peripheral quantitative computed tomography (HR-pQCT), have provided further understanding of the microstructural skeletal features in PHPT. PMID:25166047

Unilateral congenital terminal finger absences: a condition that differs from symbrachydactyly.

PubMed

Knight, Jeffrey B; Pritsch, Tamir; Ezaki, Marybeth; Oishi, Scott N

2012-01-01

To describe a type of nonhereditary unilateral transverse deficiency, which we have named hypodactyly, that is distinct from symbrachydactyly or amniotic disruption sequence. We identified 19 patients with unilateral congenital anomalies consisting of absent or short bulbous fingers that lack terminal ectodermal elements. Medical records and radiographs were retrospectively reviewed and contrasted with the typical findings of symbrachydactyly and amniotic disruption sequence. No associated syndromes or potentially causative diagnoses were identified in the hypodactyly patients. The digital absences were of a truncated pattern with thickened, tubular soft tissue coverage. Radiographs revealed a pattern of severity progression that is different from that of symbrachydactyly. Distal phalanges were the bony elements absent most frequently, followed sequentially by the middle phalanx and proximal phalanx. In all cases, metacarpals were present. Unlike symbrachydactyly, the ulnar 2 digits were more involved than the index and long fingers, and the thumb was the least involved digit. Hypodactyly appears to be a congenital hand anomaly that is clinically and radiographically different from symbrachydactyly or amniotic disruption sequence and is presumed to be caused by a distinct pathomechanism. Prognostic IV. Copyright © 2012 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

The effect of miniaturized body size on skeletal morphology in frogs.

PubMed

Yeh, Jennifer

2002-03-01

Miniaturization has evolved numerous times and reached impressive extremes in the Anura. I compared the skeletons of miniature frog species to those of closely related larger species to assess patterns of morphological change, sampling 129 species from 12 families. Two types of morphological data were examined: (1) qualitative data on bone presence and absence; and (2) thin-plate spline morphometric descriptions of skull structure and bone shape. Phylogenetic comparative methods were used to address the shared history of species. Miniature anurans were more likely to lose skull bones and phalangeal elements of the limbs. Their skulls also showed consistent differences compared to those of their larger relatives, including relatively larger braincases and sensory capsules, verticalization of lateral elements, rostral displacement of the jaw joint, and reduction of some skull elements. These features are explained by functional constraints and by paedomorphosis. Variation among lineages in the morphological response to miniaturization was also explored. Certain lineages appear to be unusually resistant to the morphological trends that characterize miniature frogs as a whole. This study represents the first large-scale examination of morphology and miniaturization across a major, diverse group of organisms conducted in a phylogenetic framework and with statistical rigor.

Tiptoeing through the rest of his life: A functional adaptation to a leg shortened by femoral neck fracture.

PubMed

Lovell, Nancy C

2016-06-01

Salvage excavation of a Roman cemetery (1st-2nd century CE) at the site of ancient Erculam (region of Campania), Italy, yielded the skeleton of an older male with a healed fracture of the femoral neck that reduced the femoral neck angle and resulted in leg shortening. The right foot shows bony alterations that appear to have developed as a consequence. The distal joint surfaces of the first and second metatarsals extend dorsally for articulation of the proximal phalanges in hyper-dorsiflexion. I argue that, in order to compensate for the shortened leg, the man lengthened it functionally by bearing weight primarily on his toes when he walked, rather than striking the heel first and then pushing off from the toe. The severity of degenerative joint disease in the right knee and in the metatarsophalangeal joints suggests that the injury occurred years before the man's death. This case adds to the bioarchaeological record of individuals who adapted to impaired mobility in the past, and it may be of interest to scholars who study the bioarchaeology of impairment and disability. Copyright © 2016 Elsevier Inc. All rights reserved.

Intrinsic properties of limb bud cells can be differentially reset.

PubMed

Saiz-Lopez, Patricia; Chinnaiya, Kavitha; Towers, Matthew; Ros, Maria A

2017-02-01

An intrinsic timing mechanism specifies the positional values of the zeugopod (i.e. radius/ulna) and then autopod (i.e. wrist/digits) segments during limb development. Here, we have addressed whether this timing mechanism ensures that patterning events occur only once by grafting GFP-expressing autopod progenitor cells to the earlier host signalling environment of zeugopod progenitor cells. We show by detecting Hoxa13 expression that early and late autopod progenitors fated for the wrist and phalanges, respectively, both contribute to the entire host autopod, indicating that the autopod positional value is irreversibly determined. We provide evidence that Hoxa13 provides an autopod-specific positional value that correctly allocates cells into the autopod, most likely through the control of cell-surface properties as shown by cell-cell sorting analyses. However, we demonstrate that only the earlier autopod cells can adopt the host proliferation rate to permit normal morphogenesis. Therefore, our findings reveal that the ability of embryonic cells to differentially reset their intrinsic behaviours confers robustness to limb morphogenesis. We speculate that this plasticity could be maintained beyond embryogenesis in limbs with regenerative capacity. © 2017. Published by The Company of Biologists Ltd.

Proximal interphalangeal joint ankylosis in an early medieval horse from Wrocław Cathedral Island, Poland.

PubMed

Janeczek, Maciej; Chrószcz, Aleksander; Onar, Vedat; Henklewski, Radomir; Skalec, Aleksandra

2017-06-01

Animal remains that are unearthed during archaeological excavations often provide useful information about socio-cultural context, including human habits, beliefs, and ancestral relationships. In this report, we present pathologically altered equine first and second phalanges from an 11th century specimen that was excavated at Wrocław Cathedral Island, Poland. The results of gross examination, radiography, and computed tomography, indicate osteoarthritis of the proximal interphalangeal joint, with partial ankylosis. Based on comparison with living modern horses undergoing lameness examination, as well as with recent literature, we conclude that the horse likely was lame for at least several months prior to death. The ability of this horse to work probably was reduced, but the degree of compromise during life cannot be stated precisely. Present day medical knowledge indicates that there was little likelihood of successful treatment for this condition during the middle ages. However, modern horses with similar pathology can function reasonably well with appropriate treatment and management, particularly following joint ankylosis. Thus, we approach the cultural question of why such an individual would have been maintained with limitations, for a probably-significant period of time. Copyright © 2017 Elsevier Inc. All rights reserved.

Oral (drinking water) developmental toxicity studies of bromodichloromethane (BDCM) in rats and rabbits.

PubMed

Christian, M S; York, R G; Hoberman, A M; Diener, R M; Fisher, L C

2001-01-01

Crl:CD(SD)IGS BR VAF/Plus (Crl SD) rats and Hra(NZW) SPF rabbits were tested for potential developmental toxicity from bromodichloromethane (BDCM) provided continuously in the drinking water during gestation (gestation days [GDs] 6 to 21 in rats and GDs 6 to 29 in rabbits). Concentrations of 0, 50, 150, 450, or 900 ppm of BDCM were used for rats; 0, 15, 150, 450, or 900 ppm were used for rabbits (in dose range-finding studies, 1350 ppm was excessively maternotoxic to both species). Investigated maternal parameters included viability, clinical signs, water and feed consumption, and body weights. Maternal gross lesions, gravid uterine weights, abnormal placentas, and numbers of corpora lutea, implantation sites, live and dead fetuses, and early and late resorptions were observed at time of Caesarean sectioning (GD 21 in rats; GD 29 in rabbits). Body weights, sex ratios, and morphological abnormalities (external, soft tissue, and skeletal) were noted in the fetuses. Mean consumed doses of BDCM were calculated to be 0, 2.2, 18.4, 45.0, or 82.0 mg/kg/day for the rats, and 0, 1.4, 13.4, 35.6, or 55.3 mg/kg/day for the rabbits (approximate human intake is 0.8 microg/kg/day [0.0008 mg/kg/day] in adults). In pregnant rats, toxicologically important, statistically significant effects included reduced absolute (g/day) and relative (g/kg/day) water consumption values at > or =50 ppm (2.2 mg/kg/day) and reduced body weight gains (also when corrected for gravid uterine weight) and absolute (g/day) and relative (g/kg/day) feed consumption values at >450 ppm (45.0 mg/kg/day). These parameters were also significantly reduced at > or =450 ppm (35.6 mg/kg/day) in pregnant rabbits (significant weight loss occurred in the rabbits at 900 ppm, i.e., 55.3 mg/kg/day). Thus, the maternal no-observable-adverse-effect level (NOAEL) for BDCM was 150 ppm, i.e., 18.4 and 13.4 mg/kg/day in rats and rabbits, respectively. No adverse effects on embryofetal viability, growth, sex ratio, gross external, soft tissue, or skeletal morphology occurred at 900 ppm in rats or rabbits. Minimal delays in the ossification of forepaw phalanges and hindpaw metatarsals and phalanges occurred in rat fetuses at 900 ppm; delays were considered marginal, reversible, and associated with severely reduced maternal weight gain. Therefore, the developmental NOAEL for rats was 450 ppm (45.0 mg/kg/day), whereas in rabbits it was 900 ppm (55.3 mg/kg/day). These NOAELs are 56,250 and 69,120 times the human adult exposure level of 0.0008 mg/kg/day, respectively. Based on the results of these studies, BDCM should not be identified as a risk to development of human conceptuses.

A molecular and clinical study of Larsen syndrome caused by mutations in FLNB.

PubMed

Bicknell, Louise S; Farrington-Rock, Claire; Shafeghati, Yousef; Rump, Patrick; Alanay, Yasemin; Alembik, Yves; Al-Madani, Navid; Firth, Helen; Karimi-Nejad, Mohammad Hassan; Kim, Chong Ae; Leask, Kathryn; Maisenbacher, Melissa; Moran, Ellen; Pappas, John G; Prontera, Paolo; de Ravel, Thomy; Fryns, Jean-Pierre; Sweeney, Elizabeth; Fryer, Alan; Unger, Sheila; Wilson, L C; Lachman, Ralph S; Rimoin, David L; Cohn, Daniel H; Krakow, Deborah; Robertson, Stephen P

2007-02-01

Larsen syndrome is an autosomal dominant osteochondrodysplasia characterised by large-joint dislocations and craniofacial anomalies. Recently, Larsen syndrome was shown to be caused by missense mutations or small inframe deletions in FLNB, encoding the cytoskeletal protein filamin B. To further delineate the molecular causes of Larsen syndrome, 20 probands with Larsen syndrome together with their affected relatives were evaluated for mutations in FLNB and their phenotypes studied. Probands were screened for mutations in FLNB using a combination of denaturing high-performance liquid chromatography, direct sequencing and restriction endonuclease digestion. Clinical and radiographical features of the patients were evaluated. The clinical signs most frequently associated with a FLNB mutation are the presence of supernumerary carpal and tarsal bones and short, broad, spatulate distal phalanges, particularly of the thumb. All individuals with Larsen syndrome-associated FLNB mutations are heterozygous for either missense or small inframe deletions. Three mutations are recurrent, with one mutation, 5071G-->A, observed in 6 of 20 subjects. The distribution of mutations within the FLNB gene is non-random, with clusters of mutations leading to substitutions in the actin-binding domain and filamin repeats 13-17 being the most common cause of Larsen syndrome. These findings collectively define autosomal dominant Larsen syndrome and demonstrate clustering of causative mutations in FLNB.

The potential of toe flexor muscles to enhance performance.

PubMed

Goldmann, Jan-Peter; Sanno, Maximilian; Willwacher, Steffen; Heinrich, Kai; Brüggemann, Gert-Peter

2013-01-01

The metatarsal phalangeal joint (MPJ) and its crossing toe flexor muscles (TFM) represent the link between the large energy generating leg extensor muscles and the ground. The purpose of this study was to examine the functional adaptability of TFM to increased mechanical stimuli and the effects on walking, running and jumping performance. Fifteen men performed a heavy resistance TFM strength training with 90% of the maximal voluntary isometric contraction (MVIC) for 7 weeks (560 contractions) for the left and right foot. Maximal MPJ and ankle plantar flexion moments during MVICs were measured in dynamometers before and after the intervention. Motion analyses (inverse dynamics) were performed during barefoot walking, running, and vertical and horizontal jumping. Athletic performance was determined by measuring jump height and distance. Left (0.21 to 0.38 Nm · kg(-1); P < 0.001) and right (0.24 to 0.40 Nm · kg(-1); P < 0.001) MPJ plantar flexion moments in the dynamometer, external MPJ dorsiflexion moments (0.69 to 0.75 Nm · kg(-1); P = 0.012) and jump distance (2.25 to 2.31 m; P = 0.006) in horizontal jumping increased significantly. TFM responded highly to increased loading within a few weeks. The increased force potential made a contribution to an athlete's performance enhancement.

Drive mechanisms to the inner and outer hair cell stereocilia

NASA Astrophysics Data System (ADS)

Maftoon, Nima; Motallebzadeh, Hamid; Guinan, John J.; Puria, Sunil

2018-05-01

It has been long believed that inner hair cell (IHC) stimulation can be gleaned from the classic ter-Kuile shear motion between the reticular lamina (RL) and tectorial membrane (TM). The present study explores this and other IHC stimulation mechanisms using a finite-element-model representation of an organ of Corti (OoC) cross section with fluid-structure interaction. A 3-D model of a cross section of the OoC including soft tissue and the fluid in the sub-tectorial space, tunnel of Corti and above the TM was formulated based on anatomical measurements from the gerbil apical turn. The outer hair cells (OHCs), Deiter's cells and their phalangeal processes are represented as Y-shaped building-block elements. Each of the IHC and OHC bundles is represented by a single sterocilium. Linearized Navier-Stokes equations coupled with linear-elastic equations discretized with tetrahedral elements are solved in the frequency domain. We evaluated the dynamic changes in the OoC motion including sub-tectorial gap dimensions for 0.1 to 10 kHz input frequencies. Calculations show the classic ter-Kuile motion but more importantly they show that the gap-height changes which produce oscillatory radial flow in the subtectorial space. Phase changes in the stereocilia across OHC rows and the IHC are also observed.

A new species of flea-toad (Anura: Brachycephalidae) from southern Atlantic Forest, Brazil.

PubMed

Condez, Thais Helena; Monteiro, Juliane Petry De Carli; Comitti, Estevão Jasper; Garcia, Paulo Christiano De Anchietta; Amaral, Ivan Borel; Haddad, Célio Fernando Baptista

2016-02-18

We describe a new species of Brachycephalus that is morphologically similar to the flea-toads B. didactylus, B. hermogenesi, and B. pulex. The new species occurs from the sea level up to 1000 m and it is widely distributed throughout southern Atlantic Forest. Brachycephalus sulfuratus sp. nov. is distinguished from all of its congeners by the combination of the following characters: (1) small body size (SVL of adults: 7.4-8.5 mm for males and 9.0-10.8 mm for females); (2) "leptodactyliform" body; (3) pectoral girdle arciferal and less robust compared to the Brachycephalus species with "bufoniform" body; (4) procoracoid and epicoracoid fused with coracoid but separated from the clavicle by a large fenestrae; (5) toe I externally absent; toes II, III, IV, and V distinct; phalanges of toes II and V reduced; (6) skin smooth with no dermal ossifications; (7) in life, general background color brown with small dark-brown spots; skin of throat, chest, arms, and forearms with irregular yellow blotches; in ventral view, cloacal region of alive and preserved specimens surrounded by a dark-brown inverted v-shaped mark outlined with white; (8) advertisement call long, composed of a set of 4-7 high-frequency notes (6.2-7.2 kHz) repeated regularly.

Discovery of a rare arboreal forest-dwelling flying reptile (Pterosauria, Pterodactyloidea) from China.

PubMed

Wang, Xiaolin; Kellner, Alexander W A; Zhou, Zhonghe; Campos, Diogenes de Almeida

2008-02-12

A previously undescribed toothless flying reptile from northeastern China, Nemicolopterus crypticus gen. et sp. nov., was discovered in the lacustrine sediments of the Early Cretaceous Jiufotang Formation, western Liaoning, China. The specimen consists of an almost complete articulated skeleton (IVPP V14377) and, despite representing an immature individual, based on the ossification of the skeleton, it is not a hatchling or newborn, making it one of the smallest pterosaurs known so far (wing span approximately 250 mm). It can be distinguished from all other pterosaurs by the presence of a short medial nasal process, an inverted "knife-shaped" deltopectoral crest of the humerus, and the presence of a well developed posterior process on the femur above the articulation with the tibia. It further shows the penultimate phalanges of the foot curved in a degree not reported in any pterosaur before, strongly indicating that it had an arboreal lifestyle, more than any other pterodactyloid pterosaur known so far. It is the sister-group of the Ornithocheiroidea and indicates that derived pterosaurs, including some gigantic forms of the Late Cretaceous with wingspans of >6 m, are closely related to small arboreal toothless creatures that likely were living in the canopies of the ancient forests feeding on insects.

Nondestructive imaging of fiber structure in articular cartilage using optical polarization tractography

NASA Astrophysics Data System (ADS)

Yao, Xuan; Wang, Yuanbo; Ravanfar, Mohammadreza; Pfeiffer, Ferris M.; Duan, Dongsheng; Yao, Gang

2016-11-01

Collagen fiber orientation plays an important role in determining the structure and function of the articular cartilage. However, there is currently a lack of nondestructive means to image the fiber orientation from the cartilage surface. The purpose of this study is to investigate whether the newly developed optical polarization tractography (OPT) can image fiber structure in articular cartilage. OPT was applied to obtain the depth-dependent fiber orientation in fresh articular cartilage samples obtained from porcine phalanges. For comparison, we also obtained collagen fiber orientation in the superficial zone of the cartilage using the established split-line method. The direction of each split-line was quantified using image processing. The orientation measured in OPT agreed well with those obtained from the split-line method. The correlation analysis of a total of 112 split-lines showed a greater than 0.9 coefficient of determination (R2) between the split-line results and OPT measurements obtained between 40 and 108 μm in depth. In addition, the thickness of the superficial layer can also be assessed from the birefringence images obtained in OPT. These results support that OPT provides a nondestructive way to image the collagen fiber structure in articular cartilage. This technology may be valuable for both basic cartilage research and clinical orthopedic applications.

Temporal Control and Hand Movement Efficiency in Skilled Music Performance

PubMed Central

Goebl, Werner; Palmer, Caroline

2013-01-01

Skilled piano performance requires considerable movement control to accomplish the high levels of timing and force precision common among professional musicians, who acquire piano technique over decades of practice. Finger movement efficiency in particular is an important factor when pianists perform at very fast tempi. We document the finger movement kinematics of highly skilled pianists as they performed a five-finger melody at very fast tempi. A three-dimensional motion-capture system tracked the movements of finger joints, the hand, and the forearm of twelve pianists who performed on a digital piano at successively faster tempi (7–16 tones/s) until they decided to stop. Joint angle trajectories computed for all adjacent finger phalanges, the hand, and the forearm (wrist angle) indicated that the metacarpophalangeal joint contributed most to the vertical fingertip motion while the proximal and distal interphalangeal joints moved slightly opposite to the movement goal (finger extension). An efficiency measure of the combined finger joint angles corresponded to the temporal accuracy and precision of the pianists’ performances: Pianists with more efficient keystroke movements showed higher precision in timing and force measures. Keystroke efficiency and individual joint contributions remained stable across tempo conditions. Individual differences among pianists supported the view that keystroke efficiency is required for successful fast performance. PMID:23300946

Prevalence of podiatric conditions seen in Special Olympics athletes: a comparison of USA data to an international population.

PubMed

Jenkins, David W; Cooper, Kimbal; Heigh, Evelyn G

2015-03-01

Persons with intellectual disabilities frequently have podiatric conditions. Limited information exists on their prevalence in international cohorts of Special Olympics (SO) athletes. Findings from multiple United States (US) venues are compared to those from athletes screened at the 2011 Special Olympics World Summer Games in Athens, Greece (ATHENS). Data from Fit Feet screenings from 2096 ATHENS participants was compared to 7192 US participants. Frequently noted in the ATHENS population were motion restriction in both the ankle and the first metatarsal phalangeal joint (1st MTPJ), pes planus, metatarsus adductus, brachymetatarsia, hallux abducto valgus (HAV), onychomycosis, onychocryptosis, and tinea pedis. ATHENS differed from the US cohort as HAV and restricted ankle joint and 1st MTPJ joint motion was less frequent. Significantly more tinea pedis, xerosis, and hyperhidrosis were present in the ATHENS population. SO athletes have a higher prevalence of podiatric structural conditions compared to the general population, and some vary between ATHENS versus US. Less prevalent in ATHENS was HAV, and restricted motion in both the ankle and 1st MTPJ. This may reflect differences due to varied clinical observers. The higher rates of several dermatological conditions in ATHENS may reflect venue seasonal climate, or social factors. Copyright © 2014 Elsevier Ltd. All rights reserved.

[The importance of handprint morphometry for determining the human body length].

PubMed

Grigor'eva, M A

2018-01-01

Handprint morphometry for the purpose of personality identification still remains a relatively novel approach. The methods employed for the measurements are not infrequently difficult to reproduce and therefore cause controversy. The objective of the present study was to introduce the system of methods for the measurement of handprints suitable for the reliable determination of the human body length. The study included the measurement of the size of 40 handprints left by124 adult subjects (52 men and 72 women). Two methods of the regression analysis, stepwise and forced inclusion, were applied to the combined group of handprints to select the equations with the high (R>0.800) coefficients of multiple correlation with the body length. 13 equations of multiple regression were obtained and analyzed. The standard error of estimating (SEE) varied from 4.30 to 5.19 cm. The best results were obtained with the equations constructed from the sizes I, II, and III of the rays without their distal phalanges. It was shown that the body length can be successfully reconstructed within the height range from 168 to 183 cm for men and from 157 to 176 cm for women. The examples of the use of the equations for the purpose of expertise of illegible and incomplete handprints are presented.

A novel CANT1 mutation in three Indian patients with Desbuquois dysplasia Kim type.

PubMed

Singh, Ankur; Kim, Ok-Hwa; Iida, Aritoshi; Park, Woong-Yang; Ikegawa, Shiro; Kapoor, Seema

2015-02-01

Desbuquois dysplasia (DBQD) is a rare skeletal dysplasia characterized by severe short stature, laxity, dislocation of multiple joints and developmental delay. DBQD is clinically heterogeneous. Distinct radiographic hand abnormalities such as the presence of extra-ossification distal to the second metacarpal or normal hand has led to its classification into types 1 and 2. Furthermore, the third type of DBQD, Kim type has been reported which is characterized by short metacarpals and elongated phalanges. However, DBQD Kim type has been exclusively reported in Japanese and Korean and its clinical characteristics remain to be delineated. Mutations in the calcium-activated nucleotidase 1 (CANT1) gene have been reported in all three types of DBQD. Previously reported patients with DBQD Kim type had a common mutation c.676G>A (p.Val226Met), which had a common founder between Japanese and Korean. Here, we report 3 Indian patients with DBQD, Kim type from 2 families which were unrelated to each other. We identified a novel mutation of CANT1, c.467C>T (p.Ser156Phe), in all the patients in the homozygous form. Our results show that DBQD Kim type is not exclusive to East Asians and also report a novel mutation from the Indian subcontinent. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Fishes and tetrapods in the upper pennsylvanian (kasimovian) cohn coal member of the mattoon formation of illinois, United States: Systematics, paleoecology, and paleoenvironments

USGS Publications Warehouse

Carpenter, D.; Falcon-Lang, H. J.; Benton, M.J.; Nelson, W.J.

2011-01-01

A newly discovered vertebrate assemblage is reported from the Upper Pennsylvanian (mid-to upper Kasimovian) Cohn Coal Member of the Mattoon Formation of southeast Illinois, United States. Teeth, scales, and spines of xenacanth (Dicentrodus, Orthacanthus, Triodus, Xenacanthus) and euselachian (Sphenacanthus) sharks dominate the assemblage. Less common are the teeth, scales, and centra of holocephalan (Helodus) and actinopterygian fishes, together with rare tetrapod (mainly pelycosaur) phalanges and centra. The assemblage occurs within a broad, shallow channel incised into a prominent Vertisol. The channel is interpreted as having been cut during a seasonally dry glacial phase when sea level was low, but filled during a subsequent transgression triggered by deglaciation. We interpret this as a brackish water (estuarine) assemblage, based on the co-occurrence of the vertebrate material with spirorbids (putative microconchids) and paleoecological inferences gleaned from a critical analysis of the literature dealing with Pennsylvanian fish ecology. This interpretation is broadly consistent with taphonomic data and the results of 87Sr/86Sr isotope analysis of shark material. The pelycosaur material may have been reworked from the lowstand Vertisol, however, and these animals occupied dryland niches that developed during glacial phases. ?? 2011 SEPM (Society for Sedimentary Geology).

Flightless I Expression Enhances Murine Claw Regeneration Following Digit Amputation.

PubMed

Strudwick, Xanthe L; Waters, James M; Cowin, Allison J

2017-01-01

The mammalian digit tip is capable of both reparative and regenerative wound healing dependent on the level of amputation injury. Removal of the distal third of the terminal phalange results in successful regeneration, whereas a more severe, proximal, amputation heals by tissue repair. Flightless I (Flii) is involved in both tissue repair and regeneration. It negatively regulates wound repair but elicits a positive effect in hair follicle regeneration, with Flii overexpression resulting in significantly longer hair fibers. Using a model of digit amputation in Flii overexpressing (FIT) mice, we investigated Flii in digit regeneration. Both wild-type and FIT digits regenerated after distal amputation with newly regenerated FIT claws being significantly longer than intact controls. No regeneration was observed in wild-type mice after severe proximal amputation; however, FIT mice showed significant regeneration of the missing digit. Using a three-dimensional model of nail formation, connective tissue fibroblasts isolated from the mesenchymal tissue surrounding the wild-type and FIT digit tips and cocultured with skin keratinocytes demonstrated aggregate structures resembling rudimentary nail buds only when Flii was overexpressed. Moreover, β-catenin and cyclin D1 expression was maintained in the FIT regenerating germinal matrix suggesting a potential interaction of Flii with Wnt signaling during regeneration. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Compact and low-cost humanoid hand powered by nylon artificial muscles.

PubMed

Wu, Lianjun; Jung de Andrade, Monica; Saharan, Lokesh Kumar; Rome, Richard Steven; Baughman, Ray H; Tadesse, Yonas

2017-02-03

This paper focuses on design, fabrication and characterization of a biomimetic, compact, low-cost and lightweight 3D printed humanoid hand (TCP Hand) that is actuated by twisted and coiled polymeric (TCP) artificial muscles. The TCP muscles were recently introduced and provided unprecedented strain, mechanical work, and lifecycle (Haines et al 2014 Science 343 868-72). The five-fingered humanoid hand is under-actuated and has 16 degrees of freedom (DOF) in total (15 for fingers and 1 at the palm). In the under-actuated hand designs, a single actuator provides coupled motions at the phalanges of each finger. Two different designs are presented along with the essential elements consisting of actuators, springs, tendons and guide systems. Experiments were conducted to investigate the performance of the TCP muscles in response to the power input (power magnitude, type of wave form such as pulsed or square wave, and pulse duration) and the resulting actuation stroke and force generation. A kinematic model of the flexor tendons was developed to simulate the flexion motion and compare with experimental results. For fast finger movements, short high-power pulses were employed. Finally, we demonstrated the grasping of various objects using the humanoid TCP hand showing an array of functions similar to a natural hand.

The mean seven years' results of the use of poly-L/D-lactic acid (PLDLA) interposition implant and bone packing in revision metacarpophalangeal arthroplasty: a prospective cohort study.

PubMed

Tiihonen, R; Honkanen, P B; Belt, E A; Ikävalko, M; Skyttä, E T

2012-01-01

Revision arthroplasty of metacarpophalangeal (MCP) joints in chronic inflammatory arthritis patients after silicone implants is challenging due of severe bone loss and soft tissue deficiencies. The aim of this study was to evaluate the outcome of revision MCP arthroplasty using poly-L/D-lactic acid 96:4 (PLDLA) interposition implant and morcelised allograft or autograft bone packing in patients with failed MCP arthroplasties and severe osteolysis. The study group consisted of 15 patients (15 hands and 36 joints) at a mean follow-up of seven years (range 5-10 years). The radiographs were reviewed for osteolysis and incorporation of the grafted bone. The clinical assessments included active range of motion, evaluation of pain, subjective outcome and assessment of grip power. PLDLA interposition arthroplasty combined with bone packing provided satisfactory pain relief, but function was limited. Radiographic analysis showed complete incorporation of the grafted bone to the diaphyseal portion of the host metacarpal and phalangeal bones in 30 of the 36 joints. All the patients had very limited grip strength, both on the operated and non-operated side. Due to soft tissue deficiencies long-term function and alignment problems can not be resolved with PLDLA interposition implant.

Oncogenic Osteomalacia Caused by a Phosphaturic Mesenchymal Tumor of the Oral Cavity: A Case Report

PubMed Central

Yang, In Myung; Park, Yong Koo; Hyun, Yong Jun; Kim, Deog Yoon; Woo, Jeong Taek; Kim, Sung Woon; Kim, Jin Woo; Kim, Young Seol; Choi, Young Kil

1997-01-01

We report a case of oncogenic osteomalacia associated with a phosphaturic mesenchymal tumor in a 31-year-old woman. She was presented with severe generalized bone and muscle pain and was restricted to bed. She lost 20cm in height over the 8 years since she had first noticed a pain in her thigh. A walnut-sized, hard, soft tissue tumor was found very easily beside her lower molar teeth. Radiologic examination revealed a remarkable decrease in bone density and multiple pathologic fractures of spine, femur and phalangeal bones. Severe hypophosphatemia, hyperphosphaturia, low plasma 1,25-dihydroxyvitamin D3 level and high plasma PTH level were disclosed at presentation. Histomorphometric examination revealed an extensive area of unmineralized osteoid and little mineralizing activity. A pharmacologic dose of 1α-hydroxyvitamin D3 or 1,25-dihydroxyvitamin D3 slightly increased the serum phosphate level and renal tubular reabsorption of phosphate, and slightly decreased plasma PTH level without any symptomatic improvement. Histologic examination of the tumor revealed a mixed connective tissue tumor that consisted of central woveh bones and surrounding primitive spindle cells with prominent vascularities. After removal of the tumor, all biochemical, hormonal and radiologic abnormalities disappeared with remarkable symptomatic improvement. PMID:9159046

Fast and fully automatic phalanx segmentation using a grayscale-histogram morphology algorithm

NASA Astrophysics Data System (ADS)

Hsieh, Chi-Wen; Liu, Tzu-Chiang; Jong, Tai-Lang; Chen, Chih-Yen; Tiu, Chui-Mei; Chan, Din-Yuen

2011-08-01

Bone age assessment is a common radiological examination used in pediatrics to diagnose the discrepancy between the skeletal and chronological age of a child; therefore, it is beneficial to develop a computer-based bone age assessment to help junior pediatricians estimate bone age easily. Unfortunately, the phalanx on radiograms is not easily separated from the background and soft tissue. Therefore, we proposed a new method, called the grayscale-histogram morphology algorithm, to segment the phalanges fast and precisely. The algorithm includes three parts: a tri-stage sieve algorithm used to eliminate the background of hand radiograms, a centroid-edge dual scanning algorithm to frame the phalanx region, and finally a segmentation algorithm based on disk traverse-subtraction filter to segment the phalanx. Moreover, two more segmentation methods: adaptive two-mean and adaptive two-mean clustering were performed, and their results were compared with the segmentation algorithm based on disk traverse-subtraction filter using five indices comprising misclassification error, relative foreground area error, modified Hausdorff distances, edge mismatch, and region nonuniformity. In addition, the CPU time of the three segmentation methods was discussed. The result showed that our method had a better performance than the other two methods. Furthermore, satisfactory segmentation results were obtained with a low standard error.

Development of a high-throughput screen to detect inhibitors of TRPS1 sumoylation.

PubMed

Brandt, Martin; Szewczuk, Lawrence M; Zhang, Hong; Hong, Xuan; McCormick, Patricia M; Lewis, Tia S; Graham, Taylor I; Hung, Sunny T; Harper-Jones, Amber D; Kerrigan, John J; Wang, Da-Yuan; Dul, Edward; Hou, Wangfang; Ho, Thau F; Meek, Thomas D; Cheung, Mui H; Johanson, Kyung O; Jones, Christopher S; Schwartz, Benjamin; Kumar, Sanjay; Oliff, Allen I; Kirkpatrick, Robert B

2013-06-01

Small ubiquitin-like modifier (SUMO) belongs to the family of ubiquitin-like proteins (Ubls) that can be reversibly conjugated to target-specific lysines on substrate proteins. Although covalently sumoylated products are readily detectible in gel-based assays, there has been little progress toward the development of robust quantitative sumoylation assay formats for the evaluation of large compound libraries. In an effort to identify inhibitors of ubiquitin carrier protein 9 (Ubc9)-dependent sumoylation, a high-throughput fluorescence polarization assay was developed, which allows detection of Lys-1201 sumoylation, corresponding to the major site of functional sumoylation within the transcriptional repressor trichorhino-phalangeal syndrome type I protein (TRPS1). A minimal hexapeptide substrate peptide, TMR-VVK₁₂₀₁TEK, was used in this assay format to afford high-throughput screening of the GlaxoSmithKline diversity compound collection. A total of 728 hits were confirmed but no specific noncovalent inhibitors of Ubc9 dependent trans-sumoylation were found. However, several diaminopyrimidine compounds were identified as inhibitors in the assay with IC₅₀ values of 12.5 μM. These were further characterized to be competent substrates which were subject to sumoylation by SUMO-Ubc9 and which were competitive with the sumoylation of the TRPS1 peptide substrates.

A new marine reptile from the Triassic of China, with a highly specialized feeding adaptation.

PubMed

Cheng, Long; Chen, Xiao-Hong; Shang, Qing-Hua; Wu, Xiao-Chun

2014-03-01

The Luoping fauna (Anisian, Middle Triassic) is probably the oldest of Triassic faunas in Guizhou-Yunnan area, China. The reptilian assemblage is comprised of ichthyosaurs, a number of sauropterygians (pachypleurosaur-like forms), saurosphargids, protorosaurs, and archosauriforms. Here, we report on a peculiar reptile, newly found in this fauna. Its dentition is fence or comb-like and bears more than 175 pleurodont teeth in each ramus of the upper and lower jaws, tooth crown is needle-like distally and blade-shaped proximally; its rostrum strongly bends downward and the anterior end of its mandible expands both dorsally and ventrally to form a shovel-headed structure; and its ungual phalanges are hoof-shaped. The specializations of the jaws and dentition indicate that the reptile may have been adapted to a way of bottom-filter feeding in water. It is obvious that such delicate teeth are not strong enough to catch prey, but were probably used as a barrier to filter microorganisms or benthic invertebrates such as sea worms. These were collected by the specialized jaws, which may have functioned as a shovel or pushdozer (the mandible) and a grasper or scratcher (the rostrum). Our preliminary analysis suggests that the new reptile might be more closely related to the Sauropterygia than to other marine reptiles.

A new marine reptile from the Triassic of China, with a highly specialized feeding adaptation

NASA Astrophysics Data System (ADS)

Cheng, Long; Chen, Xiao-Hong; Shang, Qing-Hua; Wu, Xiao-Chun

2014-03-01

The Luoping fauna (Anisian, Middle Triassic) is probably the oldest of Triassic faunas in Guizhou-Yunnan area, China. The reptilian assemblage is comprised of ichthyosaurs, a number of sauropterygians (pachypleurosaur-like forms), saurosphargids, protorosaurs, and archosauriforms. Here, we report on a peculiar reptile, newly found in this fauna. Its dentition is fence or comb-like and bears more than 175 pleurodont teeth in each ramus of the upper and lower jaws, tooth crown is needle-like distally and blade-shaped proximally; its rostrum strongly bends downward and the anterior end of its mandible expands both dorsally and ventrally to form a shovel-headed structure; and its ungual phalanges are hoof-shaped. The specializations of the jaws and dentition indicate that the reptile may have been adapted to a way of bottom-filter feeding in water. It is obvious that such delicate teeth are not strong enough to catch prey, but were probably used as a barrier to filter microorganisms or benthic invertebrates such as sea worms. These were collected by the specialized jaws, which may have functioned as a shovel or pushdozer (the mandible) and a grasper or scratcher (the rostrum). Our preliminary analysis suggests that the new reptile might be more closely related to the Sauropterygia than to other marine reptiles.

Hállux Rígidus: prospective study of joint replacement with hemiarthroplasty

PubMed Central

dos Santos, Alexandre Leme Godoy; Duarte, Fernando Aires; Seito, Carlos Augusto Itiu; Ortiz, Rafael Trevisan; Sakaki, Marcos Hideyo; Fernandes, Túlio Diniz

2013-01-01

OBJECTIVE: To report the results of medium-term follow-up after deploying Arthrosurface-HemiCap(r) in patients with diagnosis of Hállux Rigidus (HR). METHOD: Eleven patients underwent partial Arthroplasty of the first metatarsal-phalangeal joint. Six women and five men with an average age 51.9 years (46 to 58 years) and average postoperative follow-up of 3.73 years (3-4 years); were classified through the Kravitz system and evaluated by the American Orthopaedic Foot and Ankle Society (AOFAS) scales for hállux, Visual Analogical Scale (VAS) - analog functional pain - and range of motion in the first metatarsal joint in preoperative, postoperative after six months and present post-operative. RESULTS: The results show significant improvement of the three analyzed parameters, both for overall analysis and for pre and post-operative comparisons individually. The comparative analysis of each variable in the six months and the current postoperative periods do not show statistically significant differences, indicating maintenance of parameters during this interval. CONCLUSION: hemiarthroplasty of first metatarsophalangeal joint is a reproducible and safe option for the surgical treatment of hállux rigidus II and III, with significant improvement of the evaluated parameters for the studied population. Level of Evidence IV, Case Series. PMID:24453646

H syndrome: the first 79 patients.

PubMed

Molho-Pessach, Vered; Ramot, Yuval; Camille, Frances; Doviner, Victoria; Babay, Sofia; Luis, Siekavizza Juan; Broshtilova, Valentina; Zlotogorski, Abraham

2014-01-01

H syndrome is an autosomal recessive genodermatosis with multisystem involvement caused by mutations in SLC29A3. We sought to investigate the clinical and molecular findings in 79 patients with this disorder. A total of 79 patients were included, of which 13 are newly reported cases. Because of the phenotypic similarity and molecular overlap with H syndrome, we included 18 patients with allelic disorders. For 31 patients described by others, data were gathered from the medical literature. The most common clinical features (>45% of patients) were hyperpigmentation, phalangeal flexion contractures, hearing loss, and short stature. Insulin-dependent diabetes mellitus and lymphadenopathy mimicking Rosai-Dorfman disease were each found in approximately 20%. Additional systemic features were described in less than 15% of cases. Marked interfamilial and intrafamilial clinical variability exists. Twenty mutations have been identified in SLC29A3, with no genotype-phenotype correlation. In the 31 patients described by others, data were collected from the medical literature. H syndrome is a multisystemic disease with clinical variability. Consequently, all SLC29A3-related diseases should be considered a single entity. Recognition of the pleomorphic nature of H syndrome is important for diagnosis of additional patients. Copyright © 2013 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Distractor objects affect fingers' angular distances but not fingers' shaping during grasping.

PubMed

Ansuini, Caterina; Tognin, Veronica; Turella, Luca; Castiello, Umberto

2007-04-01

The aim of the present study was to determine whether and how hand shaping was affected by the presence of a distractor object adjacent to the to-be-grasped object. Twenty subjects were requested to reach towards and grasp a 'convex' or a 'concave' object in the presence or absence of a distractor object either of the same or different shape than the target object. Flexion/extension at the metacarpal-phalangeal (MCP) and proximal interphalangeal joints of all digits, and abduction angle between digits were measured by resistive sensors embedded in a glove. The results indicate robust interference effects at the level of reach duration and the extent of fingers' abduction angles together with changes at the level of a single joint for the thumb. No distractor effects on individual fingers' joints except for the MCP of the middle and little fingers were found. These findings suggest that the presence of distractor object affects hand shaping in terms of fingers' abduction angles, but not at the level of 'shape dependent' fingers' angular excursions. Furthermore, they support the importance of the thumb for the guidance of selective reach-to-grasp movements. We discuss these results in the context of current theories proposed to explain the object selection processes underlying the control of hand action.

Upstroke wing flexion and the inertial cost of bat flight

PubMed Central

Riskin, Daniel K.; Bergou, Attila; Breuer, Kenneth S.; Swartz, Sharon M.

2012-01-01

Flying vertebrates change the shapes of their wings during the upstroke, thereby decreasing wing surface area and bringing the wings closer to the body than during downstroke. These, and other wing deformations, might reduce the inertial cost of the upstroke compared with what it would be if the wings remained fully extended. However, wing deformations themselves entail energetic costs that could exceed any inertial energy savings. Using a model that incorporates detailed three-dimensional wing kinematics, we estimated the inertial cost of flapping flight for six bat species spanning a 40-fold range of body masses. We estimate that folding and unfolding comprises roughly 44 per cent of the inertial cost, but that the total inertial cost is only approximately 65 per cent of what it would be if the wing remained extended and rigid throughout the wingbeat cycle. Folding and unfolding occurred mostly during the upstroke; hence, our model suggests inertial cost of the upstroke is not less than that of downstroke. The cost of accelerating the metacarpals and phalanges accounted for around 44 per cent of inertial costs, although those elements constitute only 12 per cent of wing weight. This highlights the energetic benefit afforded to bats by the decreased mineralization of the distal wing bones. PMID:22496186

Segmentation and determination of joint space width in foot radiographs

NASA Astrophysics Data System (ADS)

Schenk, O.; de Muinck Keizer, D. M.; Bernelot Moens, H. J.; Slump, C. H.

2016-03-01

Joint damage in rheumatoid arthritis is frequently assessed using radiographs of hands and feet. Evaluation includes measurements of the joint space width (JSW) and detection of erosions. Current visual scoring methods are timeconsuming and subject to inter- and intra-observer variability. Automated measurement methods avoid these limitations and have been fairly successful in hand radiographs. This contribution aims at foot radiographs. Starting from an earlier proposed automated segmentation method we have developed a novel model based image analysis algorithm for JSW measurements. This method uses active appearance and active shape models to identify individual bones. The model compiles ten submodels, each representing a specific bone of the foot (metatarsals 1-5, proximal phalanges 1-5). We have performed segmentation experiments using 24 foot radiographs, randomly selected from a large database from the rheumatology department of a local hospital: 10 for training and 14 for testing. Segmentation was considered successful if the joint locations are correctly determined. Segmentation was successful in only 14%. To improve results a step-by-step analysis will be performed. We performed JSW measurements on 14 randomly selected radiographs. JSW was successfully measured in 75%, mean and standard deviation are 2.30+/-0.36mm. This is a first step towards automated determination of progression of RA and therapy response in feet using radiographs.

Radiological investigations of the hedgehog (Erinaceus concolor) appendicular skeleton.

PubMed

Hashemi, Mohammad; Javadi, Shahram; Hadian, Mojtaba; Pourreza, Behzad; Behfar, Mahdi

2009-03-01

The normal radiographic anatomy of the healthy hedgehog can help to identify anatomic features unique to the hedgehog while comparing it with other small mammals, such as the dog and cat. Radiographic examination is a method that can play an important role in the diagnosis of a wide variety of skeletal diseases. Seven (2 males, 5 females) free-living hedgehogs (Erinaceus concolor) from the Urmia region of Iran were selected for this study. Lateral and craniocaudal radiographs from the front and hind limbs were obtained. The radiographs from these hedgehogs were compared with the normal canine and feline skeletal radiographic anatomy. On the forelimb radiographs, the clavicle was observed as a complete bone connected to the scapula and manubrium. There are three and five carpal bones in the proximal and distal rows, respectively, as in the dog and cat. The pelvis has a larger obturator foramen when compared with the dog and cat. In the lateral view, the pubis and ischium are relatively larger than in the dog and cat and have a more ventral position. The tarsal bones are similar to those of the dog and cat. The number of phalanges and sesamoid bones in the forelimb and hindlimb are likewise similar to those found in the dog and cat.

Bone mineral mass and width in normal white women and men

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schlenker, R.A.; Oltman, B.G.; Kotek, T.J.

1976-06-01

Bone mineral content (BMC) and width (W) have been measured in approximately 600 white women and 100 white men ranging from the teens to the 80s. Measurements were made using the /sup 125/I photon absorptiometric method at five pairs of contralateral sites with the arm in the prone position: the midshafts of the right and left radii and ulnae, the distal metaphyses of the right and left radii and ulnae, and the distal diaphyses of the right and left third proximal phalanges. Most subjects were from a group who had abnormally high body burdens of /sup 226/Ra. A large fractionmore » of radium intake to the body is deposited in the skeleton and these subjects were studied to determine if irradiation of bone by radium alpha particles affected the BMC. There was no relation of BMC to radiation dose, although for high doses there were depressions in BMC when scanning across osteolytic lesions. The data here are for subjects who had /sup 226/Ra body burdens less than 100 nCi plus persons who were unexposed to radium. Body burdens of 100 nCi /sup 226/Ra cause no radiographic skeletal abnormalities. This and the absence of a correlation between BMC and radiation dose indicated that our radium-exposed subjects had normal skeletons.« less

Achondroplastic Dwarfism—Effects of Treatment with Human Growth Hormone

PubMed Central

Escamilla, Roberto F.; Hutchings, John J.; Li, Choh Hao; Forsham, Peter

1966-01-01

Two male patients with achondroplastic dwarfism aged 7-5/12 and 14½ years were treated with human growth hormone 5 mg daily. Both showed nitrogen retention on balance studies, the older second patient to a marked degree. In the younger patient, height increased from 95.4 to 106.3 cm on hgh 5 mg daily alone for 14 out of 24 months. The rate of growth approximately doubled during the first two treatment periods as compared with the pre-treatment rate. In the second older patient hgh was administered 5 mg daily intramuscularly for 21 out of 33 months. Growth from 129.6 cm to 137.8 cm occurred with the rate increasing following the addition of Na-1-thyroxine to the routine. This increased growth rate occurred during the post-puberty deceleration phase. Bone ages, interpreted from changes in the phalanges and metacarpals, increased from 4½ to 6 years during 16 months in Case 1, and from 13½ to 18 years in 33 months in Case 2. Transient adolescent gynecomastia appeared in Case 2. No local or general toxic effects were noted. These results are suggestive, but whether or not the eventual height of an achondroplastic dwarf can be significantly altered must await further studies. ImagesFigure 1.Figure 2. PMID:5946547

Assessment of thermotactile and vibrotactile thresholds for detecting sensorineural components of the hand-arm vibration syndrome (HAVS).

PubMed

Ye, Ying; Griffin, Michael J

2018-01-01

Thermotactile thresholds and vibrotactile thresholds are measured to assist the diagnosis of the sensorineural component of the hand-arm vibration syndrome (HAVS). This study investigates whether thermotactile and vibrotactile thresholds distinguish between fingers with and without numbness and tingling. In 60 males reporting symptoms of the hand-arm vibration syndrome, thermotactile thresholds for detecting hot and cold temperatures and vibrotactile thresholds at 31.5 and 125 Hz were measured on the index and little fingers of both hands. In fingers reported to suffer numbness or tingling, hot thresholds increased, cold thresholds decreased, and vibrotactile thresholds at both 31.5 and 125 Hz increased. With sensorineural symptoms on all three phalanges (i.e. numbness or tingling scores of 6), both thermotactile thresholds and both vibrotactile thresholds had sensitivities greater than 80% and specificities around 90%, with areas under the receiver operating characteristic curves around 0.9. There were correlations between all four thresholds, but cold thresholds had greater sensitivity and greater specificity on fingers with numbness or tingling on only the distal phalanx (i.e. numbness or tingling scores of 1) suggesting cold thresholds provide better indications of early sensorineural disorder. Thermotactile thresholds and vibrotactile thresholds can provide useful indications of sensorineural function in patients reporting symptoms of the sensorineural component of HAVS.

Temperature perception on the hand during static vs. dynamic contact with a surface

PubMed Central

Green, Barry G.

2010-01-01

Innocuous cooling or heating of the forearm can evoke nociceptive sensations such as burning, stinging, and pricking (‘low-threshold thermal nociception’, LTN) that are inhibited by dynamic contact. The present study investigated whether LTN can also be perceived on the hand, and if so, whether it is normally suppressed by active touching. Innocuous cold (28°, 25° and 18°C) and warm (38°, 40° and 43°C) temperatures were delivered to the distal metacarpal pads and intermediate and distal phalanges of the fingers via a handgrip thermode that subjects either statically held or actively grasped. The same temperatures were delivered to the forearm via another thermode that either rested on the arm or was touched to the arm. Subjects rated the intensity of thermal (warmth, cold) and nociceptive (e.g., burning) sensations and indicated the qualities of sensation experienced. The results showed that LTN can be perceived on the hand, although less frequently and less intensely than on the forearm. Dynamic contact inhibited nociceptive and thermal sensations on the hand, though less strongly than on the forearm. These findings indicate that temperature perception on the hand is attenuated and its quality changed when thermal stimulation is accompanied by dynamic tactile stimulation, as during haptic exploration. PMID:19525547

Epidermoid Cyst of Mandible Ramus: Case Report.

PubMed

Loxha, Mergime Prekazi; Salihu, Sami; Kryeziu, Kaltrina; Loxha, Sadushe; Agani, Zana; Hamiti, Vjosa; Rexhepi, Aida

2016-06-01

An epidermoid cyst is a benign cyst usually found on the skin. Bone cysts are very rare and if they appear in bone they usually appear in the distal phalanges of the fingers. Epidermoid cysts of the jaws are uncommon. We present a case, of a 41 year-old female patient admitted to our department because of pain and swelling in the parotid and masseteric region-left side. There was no trismus, pathological findings in skin, high body temperature level, infra-alveolar nerves anesthesia or lymphadenopathy present. The orthopantomography revealed a cystic lesion and a unilocular lesion that included mandibular ramus on the left side with 3 cm in diameter. Under total anesthesia, a cyst had been reached and was enucleated. Histopathologic findings showed that the pathologic lesion was an epidermoid cyst. Epidermoid and dermoid cysts are rare, benign lesions found throughout the body. Only a few cases in literature describe an intraossesus epidermoid cyst. Our case is an epidermoid cyst with a rare location in the region of the mandibular ramus. It is not associated with any trauma in this region except medical history reveals there was an operative removal of a wisdom tooth 12 years ago in the same side. These cysts are interesting from the etiological point of view. They should be considered in the differential diagnosis of other radiolucent lesions of the jaws. Surgically they have a very good prognosis, and are non-aggressive lesions.

Hallux valgus (bunions)

PubMed Central

2014-01-01

Introduction Hallux valgus (bunions) are prominent and often inflamed metatarsal heads and overlying bursae. They are associated with valgus deviation of the great toe which moves towards the second toe. Hallux valgus is found in at least 2% of children aged 9 to 10 years, and almost half of adults, with greater prevalence in women. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of conservative treatments for hallux valgus (bunions)? What are the effects of osteotomy for hallux valgus (bunions)? We searched: Medline, Embase, The Cochrane Library, and other important databases up to October 2013 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 15 studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review, we present information relating to the effectiveness and safety of the following interventions: chevron osteotomy plus adductor tenotomy; distal metatarsal osteotomy; minimally invasive surgery (percutaneous distal metatarsal osteotomy, SERI [Simple, Effective, Rapid, Inexpensive] distal metatarsal osteotomy); phalangeal (Akin) osteotomy plus distal chevron osteotomy; proximal osteotomy; night splints; and orthoses (including antipronatory orthoses in children).

Foot shape in arboreal birds: two morphological patterns for the same pincer-like tool.

PubMed

Abourachid, Anick; Fabre, Anne-Claire; Cornette, Raphaël; Höfling, Elizabeth

2017-07-01

The feet are the only contact between the body and the substrate in limbed animals and as such they provide a crucial interface between the animal and its environment. This is especially true for bipedal and arboreal species living in a complex three-dimensional environment that likely induces strong selection on foot morphology. In birds, foot morphology is highly variable, with different orientations of the toes, making it a good model for the study of the role of functional, developmental, and phylogenetic constraints in the evolution of phenotypic diversity. Our data on the proportions of the phalanges analyzed in a phylogenetic context show that two different morphological patterns exist that depend mainly on habitat and toe orientation. In the anisodactyl foot, the hallux is the only backward-oriented toe and is enlarged in climbing species and reduced in terrestrial ones. Moreover, a proximo-distal gradient in phalanx size is observed depending on the degree of terrestriality. In the two other cases (heterodactyl and zygodactyl) that have two toes that point backward, the hallux is rather small in contrast to the other backward-pointing toe, which is enlarged. The first pattern is convergent and common among tetrapods and follows rules of skeletal development. The second pattern is unique for the clade and under muscle-morphogenetic control. In all cases, the functional result is the same tool, a pincer-like foot. © 2017 Anatomical Society.

Manual Loading Distribution During Carrying Behaviors: Implications for the Evolution of the Hominin Hand

PubMed Central

Key, Alastair J. M.

2016-01-01

The human hand is unparalleled amongst primates in its ability to manipulate objects forcefully and dexterously. Previous research has predominantly sought to explain the evolution of these capabilities through an adaptive relationship between more modern human-like anatomical features in the upper limb and increased stone tool production and use proficiency. To date, however, we know little about the influence that other manipulatively demanding behaviors may have had upon the evolution of the human hand. The present study addresses one aspect of this deficiency by examining the recruitment of the distal phalanges during a range of manual transportation (i.e., carrying) events related to hominin behavioral repertoires during the Plio-Pleistocene. Specifically, forces on the volar pad of each digit are recorded during the transportation of stones and wooden branches that vary in weight and size. Results indicate that in most instances, the index and middle fingers are recruited to a significantly greater extent than the other three digits during carrying events. Relative force differences between digits were, however, dependent upon the size and weight of the object transported. Carrying behaviors therefore appear unlikely to have contributed to the evolution of the robust thumb anatomy observed in the human hand. Rather, results suggest that the manual transportation of objects may plausibly have influenced the evolution of the human gripping capabilities and the 3rd metacarpal styloid process. PMID:27695044

Radiographic changes of the distal phalangeal tuft of the hands in subjects with systemic sclerosis. Systematic review.

PubMed

Izquierdo, Yojhan Edilberto; Calvo Páramo, Enrique; Castañeda, Luisa María; Gómez, Sandra Viviana; Zambrano, Fernán Santiago

To determine abnormal plain radiograph findings of the distal phalanx tuft of the hand (DPTH) associated with systemic sclerosis in adults. A systematic review was developed following the parameters of the PRISMA guidelines in databases: MEDLINE, EMBASE, BIREME, Scielo, Google Scholar and others including as primary outcomes alterations of DPTH (erosions, resorption, sclerosis and proliferation) detected by simple radiography in subjects with systemic sclerosis. The prevalence of radiographic findings was synthesized using the fixed effects model. The statistical associations were expressed in terms of relative risk or odds ratio with their respective confidence intervals and p values. Twenty-two observational studies were included; the prevalence of DPTH resorption was 28.3% (95% CI: 0.256-0.312; p < .001); I 2 =80.4%, the prevalence of calcinosis was 15.6% (95% CI: 0.113-0.210; p < .001); I 2 =0%. No study reported proliferation or erosions and only one study described sclerosis of DPTH in 5 individuals. Resorption and calcinosis of DPTH are the characteristic radiographic findings in patients with systemic sclerosis. However, new studies with greater methodological strength are needed to establish associations between these phenomena and their presence in other connective tissue diseases. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

Correlates of the peak height velocity in girls with idiopathic scoliosis.

PubMed

Sanders, James O; Browne, Richard H; Cooney, Timothy E; Finegold, David N; McConnell, Sharon J; Margraf, Susan A

2006-09-15

Prospective longitudinal. Determine correlates of the peak height velocity (PHV) in girls with idiopathic scoliosis. Only identifiable retrospectively, the PHV is the most useful known maturity marker in idiopathic scoliosis. Clinically useful correlates are needed to make PHV timing helpful. A total of 24 immature girls with idiopathic scoliosis were followed with serial heights, sexual staging, skeletal ages, spinal radiographs, insulin-like growth factor (IGF)-1, IGF binding protein-3, dehydroepiandrosterone sulfate, estradiol, bone-specific alkaline phosphatase, and osteocalcin levels. These markers were correlated to PHV timing. There were 14 girls who had identifiable growth peaks that averaged 10.5 +/- 1.8 cm/y at age 11.7 +/- 1 years. At the PHV, all girls were Risser 0 with open triradiate cartilages. On a skeletal age radiograph, digital uncapped phalangeal epiphyses were indicative of pre-PHV and fused epiphyses of post-PHV. Capped but unfused epiphyses were indeterminate. Tanner stage 1 for breast strongly indicates pre-PHV. Stage 3 for breast and pubic hair occurred at or after the PHV, and stage 4 always occurred after PHV. Higher IGF-1 and estradiol levels after PHV are potentially discriminatory. The PHV occurs during Risser 0 with open triradiate cartilages. If triradiate cartilages are open, then Tanner stages, IGF-1, estradiol levels, and the appearance of the epiphyses on a skeletal age radiograph are useful in determining status before or after PHV.

Evaluation of nitroglycerin effect on remote photoplethysmogram waveform acquired at green and near infra-red illumination

NASA Astrophysics Data System (ADS)

Marcinkevics, Z.; Rubins, U.; Caica, A.; Grabovskis, A.

2017-12-01

Assessment of skin microcirculation provides diagnostically valuable information during the early stages of pathologies. The simple, cost-effective and intrusive alternative to existing circulation assessment methods is remote photoplethysmography (rPPG). The objective of the present pilot study was to reveal an effect on sublingual administration of 1 mg nitroglycerin on systemic hemodynamic parameters and rPPG waveforms, at 810 nm and 530nm illumination. The protocol comprised 3 minutes of baseline recording, 15 minutes recording of NTG effect, 2 minutes of arterial occlusion and the following 3 min reactive hyperemia. Two PPG signals were acquired from glabrous skin of the middle finger distal phalange, consecutively at 530 nm and 810nm, 125 fps per channel, and systemic cardiovascular parameters were continuously registered in a beat-to-beat manner with a Finameter-midi system. The NTG effect was observed 0.7- 1.2 minutes post administration, reaching its maximum after 3 minutes. Systemic cardiovascular parameters significantly changed: mean arterial pressure decreased by 7.7+/-3.6%, total peripheral resistance by 10.5+/-9.0%, whereas the heart rate increased by 27.2+/-11.8%. Substantial alterations were observed for rPPG waveforms during NTG effect, decreasing reflection and stiffness indices. It has been concluded that rPPG waveform may provide information related to arterial stiffness, and could be potentially utilized in the clinics.

Bilateral Radial Agenesis in a Cat Treated with Bilateral Ulnocarpal Arthrodesis.

PubMed

Bezhentseva, Alla; Singh, Harpreet; Boudrieau, Randy J

2018-06-20

 This article describes corrective antebrachiocarpal re-alignment and arthrodesis for bilateral radial hemimelia (radial agenesis) in an 8-month-old domestic short-haired cat.  Bilateral forelimb deformity of ulnocarpal varus with complete luxation and rotation of the antebrachiocarpal joint spaces, and joint contracture, was observed. Several carpal bones and metacarpal bones I and II and their associated phalanges were absent. Abnormal ambulation and weight bearing on the dorsolateral part of the manus were present. The deformities were treated by bilateral distal ulnar ostectomy and ulnocarpal arthrodesis using a 2.0-mm locking compression plate applied with hybrid fixation and allograft.  Successful deformity correction was obtained with subsequent fusion of the antebrachiocarpal joints. No complications were observed. At long-term follow-up (4.75 years), there was good-to-excellent functional result, with approximately 15° internal rotation of the right forelimb manus and shortened stride with slight circumduction and lameness. All implants remained stable and continued bone remodelling was present. The cat was assessed to have good-to-excellent short- and long-term functional results with excellent owner satisfaction.  Treatment of radial agenesis in the cat has previously been limited to conservative management or limb amputation. While there are several reports of corrective limb-sparing procedures used to treat dogs, this is the first report of a cat with successful salvage corrective surgery. Schattauer GmbH Stuttgart.

At the foot of the shrew: Manus morphology distinguishes closely-related Cryptotis goodwini and Cryptotis griseoventris (Mammalia: Soricidae) in Central America

USGS Publications Warehouse

Woodman, Neal; Stephens, Ryan B.

2010-01-01

Small-eared shrews (Mammalia, Soricidae) of the New World genus Cryptotis are distributed from eastern North America to the northern Andes of South America. One well-defined clade in this genus is the Central American Cryptotis mexicana group, whose members are set off from other species in the genus by their variably broader fore feet and more elongate and broadened fore claws. Two species in the C. mexicana group, Cryptotis goodwini Jackson and Cryptotis griseoventris Jackson, inhabit highlands in Guatemala and southern Mexico and are presumed to be sister species whose primary distinguishing feature is the larger body size of C. goodwini. To better characterize these species and confirm the identification of recently-collected specimens, we obtained digital X-ray images of the manus from large series of dried skins of both species. Measurements of the metacarpals and phalanges successfully separated most specimens of C. goodwini and C. griseoventris. These measurements also show that the fore feet of C. griseoventris from Chiapas, Mexico, are morphologically distinct from those of members of the species inhabiting Guatemala. Univariate, bivariate, and multivariate analyses indicate that fore foot characters are more conservative within species of the C. mexicana group than are cranio-mandibular characters. Patterns of evolution of fore foot characters that superficially appear to be linear gradations are actually more complex, illustrating individual evolutionary trajectories.

Bone age assessment by content-based image retrieval and case-based reasoning

NASA Astrophysics Data System (ADS)

Fischer, Benedikt; Welter, Petra; Grouls, Christoph; Günther, Rolf W.; Deserno, Thomas M.

2011-03-01

Skeletal maturity is assessed visually by comparing hand radiographs to a standardized reference image atlas. Most common are the methods by Greulich & Pyle and Tanner & Whitehouse. For computer-aided diagnosis (CAD), local image regions of interest (ROI) such as the epiphysis or the carpal areas are extracted and evaluated. Heuristic approaches trying to automatically extract, measure and classify bones and distances between bones suffer from the high variability of biological material and the differences in bone development resulting from age, gender and ethnic origin. Content-based image retrieval (CBIR) provides a robust solution without delineating and measuring bones. In this work, epiphyseal ROIs (eROIS) of a hand radiograph are compared to previous cases with known age, mimicking a human observer. Leaving-one-out experiments are conducted on 1,102 left hand radiographs and 15,428 metacarpal and phalangeal eROIs from the publicly available USC hand atlas. The similarity of the eROIs is assessed by a combination of cross-correlation, image distortion model, and Tamura texture features, yielding a mean error rate of 0.97 years and a variance of below 0.63 years. Furthermore, we introduce a publicly available online-demonstration system, where queries on the USC dataset as well as on uploaded radiographs are performed for instant CAD. In future, we plan to evaluate physician with CBIR-CAD against physician without CBIR-CAD rather than physician vs. CBIR-CAD.

Comparison of three methods to assess individual skeletal maturity.

PubMed

Pasciuti, Enzo; Franchi, Lorenzo; Baccetti, Tiziano; Milani, Silvano; Farronato, Giampietro

2013-09-01

The knowledge of facial growth and development is fundamental to determine the optimal timing for different treatment procedures in the growing patient. To analyze the reproducibility of three methods in assessing individual skeletal maturity, and to evaluate any degree of concordance among them. In all, 100 growing subjects were enrolled to test three methods: the hand-wrist, cervical vertebral maturation (CVM), and medial phalanges of the third finger method (MP3). Four operators determined the skeletal maturity of the subjects to evaluate the reproducibility of each method. After 30 days the operators repeated the analysis to assess the repeatability of each method. Finally, one operator examined all subjects' radiographs to detect any concordance among the three methods. The weighted kappa values for inter-operator variability were 0.94, 0.91, and 0.90, for the WRI, CVM, and MP3 methods, respectively. The weighted kappa values for intra-operator variability were 0.92, 0.91, and 0.92, for the WRI, CVM, and MP3 methods, respectively. The three methods revealed a high degree of repeatability and reproducibility. Complete agreement among the three methods was observed in 70% of the analyzed samples. The CVM method has the advantage of not necessitating an additional radiograph. The MP3 method is a simple and practical alternative as it requires only a standard dental x-ray device.

Outcome of limb fracture repair in rabbits: 139 cases (2007-2015).

PubMed

Sasai, Hiroshi; Fujita, Daisuke; Seto, Eiko; Denda, Yuki; Imai, Yutaro; Okamoto, Kanako; Okamura, Kensaku; Furuya, Masaru; Tani, Hiroyuki; Sasai, Kazumi

2018-02-15

OBJECTIVE To evaluate outcome of limb fracture repair in rabbits. DESIGN Retrospective case series. ANIMALS 139 client-owned rabbits with limb fractures treated between 2007 and 2015. PROCEDURES Medical records were reviewed for information on fracture location, fracture treatment, and time to fracture healing. RESULTS 25 rabbits had fractures involving the distal aspects of the limbs (ie, metacarpal or metatarsal bones, phalanges, and calcaneus or talus). Fractures were treated in 23 of these 25 rabbits (external coaptation, n = 17; external skeletal fixation, 4; and intramedullary pinning, 2) and healed in all 23, with a median healing time of 28 days (range, 20 to 45 days). One hundred ten rabbits had long bone fractures, and fractures were treated in 100 of the 110 (external skeletal fixation, n = 89; bone plating, 1; intramedullary pinning, 3; and external coaptation, 7). The percentage of fractures that healed was significantly lower for open (14/18) than for closed (26/26) tibial fractures and was significantly lower for femoral (19/26) and treated humeral (4/6) fractures than for radial (23/24) or closed tibial (26/26) fractures. Micro-CT was used to assess fracture realignment during external skeletal fixator application and to evaluate fracture healing. CONCLUSIONS AND CLINICAL RELEVANCE The prognosis for rabbits with limb fractures was good, with fractures healing in most rabbits following fracture repair (109/123). Micro-CT was useful in assessing fracture realignment and evaluating fracture healing.

The potential of human toe flexor muscles to produce force

PubMed Central

Goldmann, Jan-Peter; Brüggemann, Gert-Peter

2012-01-01

The maximal force a muscle produces depends among others on the length of the muscle and therefore on the positions of the joints the muscle crosses. Long and short toe flexor muscles (TFM) cross the ankle joints and metatarsal phalangeal joints (MPJ) and work against gravity during human locomotion. The purpose of this study was to describe the maximal moments around the MPJ during maximal voluntary isometric contractions (MVIC) of the TFM as a function of ankle joint and MPJ position. Twenty men performed MVIC of the TFM in a custom-made dynamometer. Ankle and MPJ angles were modified after each contraction. External moments of force around the MPJ were determined. Moments ranged between 6.3 ± 2.6 Nm and 14.2 ± 5.8 Nm. Highest moments were produced at 0°–10° ankle joint dorsal flexion and 25°–45° MPJ dorsal flexion. Lowest moments were generated at 35° ankle joint plantar flexion and 0° MPJ dorsal flexion. In conclusion, if the ankle is plantar-flexed, dorsal flexion of the MPJ avoids a disadvantage of the force–length relationship of TFM. Therefore, MPJ dorsal flexion is a necessary function in the push-off phase of human locomotion to work against the loss of the mechanical output at the forefoot caused by plantar flexion of the ankle. PMID:22747582

Development and evolution of the mammalian limb: adaptive diversification of nails, hooves, and claws.

PubMed

Hamrick, M W

2001-01-01

Paleontological evidence indicates that the evolutionary diversification of mammals early in the Cenozoic era was characterized by an adaptive radiation of distal limb structures. Likewise, neontological data show that morphological variation in distal limb integumentary appendages (e.g., nails, hooves, and claws) can be observed not only among distantly related mammalian taxa but also among closely related species within the same clade. Comparative analysis of nail, claw, and hoof morphogenesis reveals relatively subtle differences in mesenchymal and epithelial patterning underlying these adult differences in distal limb appendage morphology. Furthermore, studies of regulatory gene expression during vertebrate claw development demonstrate that many of the signaling molecules involved in patterning ectodermal derivatives such as teeth, hair, and feathers are also involved in organizing mammalian distal limb appendages. For example, Bmp4 signaling plays an important role during the recruitment of mesenchymal cells into the condensations forming the terminal phalanges, whereas Msx2 affects the length of nails and claws by suppressing proliferation of germinal epidermal cells. Evolutionary changes in the form of distal integumentary appendages may therefore result from changes in gene expression during formation of mesenchymal condensations (Bmp4, posterior Hox genes), induction of the claw fold and germinal matrix (shh), and/or proliferation of epidermal cells in the claw matrix (Msx1, Msx2). The prevalence of convergences and parallelisms in nail and claw structure among mammals underscores the existence of multiple morphogenetic pathways for evolutionary change in distal limb appendages.

Melorheostosis: case report with 20-year follow-up.

PubMed

Pavone, Vito; Evola, Roberto Francesco; Di Giorgio, Angelo; Ruggieri, Martino; Ardito, Salvatore

2008-05-01

The authors report on a typical case of melorheostosis observed in an 18-year-old man, localized in the II digit of the right hand causing tumefaction and irregular pain. At 20-year follow-up, the patient showed a radiographical slight worsening of the lesion. Radiographic examination showed a mild increase in cortical and endosteal hyperostosis with bone shape alteration in the II digit of the right hand, slight cortical and endosteal hyperostosis at the level of right shoulder girdle involving the humerus. The other part of the skeleton was not affected. Clinical examination revealed swelling and tumefaction of the forefinger of the right hand and reduced articular motion both in proximal and distal interphalangeal joint and metacarpal phalangeal joint. The reminder of the clinical examination was normal. Melorheostosis is an uncommon mesenchymal disorder characterized by a chondral hyperostosis of the long bones associated to a sclerosis of the spongious bone. The etiology of this affection is unknown: the most accredited hypothesis is a developmental anomaly with a sequential sclerotomes distribution. Both genders may be affected, with the long tubular bones of the lower limbs more involved. This anomaly is often asymptomatic but maybe accompanied by pain with a smooth symptom progression and periodic exacerbations. Therapy is mainly symptomatic and comprises anti-inflammatory drugs or surgical approach for removal of soft tissue that may preclude daily activities. This case report demonstrates that melorheostosis is a relatively benign disorder with mildly progressive course.

Case report: Emergency department diagnosis of melorheostosis in the upper extremity: a rare disease with an unusual presentation.

PubMed

Murano, Tiffany; Egarian, Michele

2012-10-01

Melorheostosis is a rare disease that affects fewer than 1:1,000,000 persons worldwide and most typically affects the lower extremities. It is a non-hereditary disease that may be debilitating due to chronic pain, contractures of the soft tissue, and even shortening of the affected limbs. Although it most commonly occurs in the lower extremities, melorheostosis has been reported in various locations throughout the body. This case report describes a patient who presented to the Emergency Department (ED) with this rare disease in an uncommonly affected bone. The patient was a 21-year-old man who presented to the ED with pain in his left upper extremity that he attributed to playing sports 3 days before presentation. Plain films revealed periosteal hyperostosis typical of melorheostosis in several of his carpals, metacarpals, and phalanges, as well as the humerus and ulna. The patient was discharged with orthopedic follow-up and pain medication. Melorheostosis is a rare disease that has characteristic radiographic findings likened to the appearance of melting wax flowing down the side of a candle. In certain cases, the disease can be debilitating and may require chronic pain management and even operative intervention. If this diagnosis is made in the ED, the emergency physician should provide adequate pain management and refer the patient to an orthopedic specialist for a work-up to rule out other sclerosing bone dysplasias. Copyright © 2012 Elsevier Inc. All rights reserved.

Quantitative Analysis and Development of the Fore Feet of Arabian Foals from Birth to 1 Year of Age.

PubMed

Faramarzi, Babak; Salinger, Allison; Kaneps, Andris; Nout-Lomas, Yvette; Greene, Holly; Dong, Fanglong

2017-11-01

Objectives  The goal of this study was to quantify external and internal anatomical characteristics of the foal foot throughout the first year of age. Methods  Digital radiographs and photographs were taken bimonthly of the forefeet of nine Arabian foals, beginning at about 2 weeks of age until 12 months of age. Sixty-eight linear and angular variables were measured using NIH (National Institutes of Health) Image J software. Statistical analyses were performed using piecewise random coefficient model and p -values < 0.05 were considered significant. Results  Distinct changes in hoof development were identified between 4 and 8 months of age. Distinct changes were identified in several external (conformational) measurements including hoof solar widths and lengths, palmar heel lengths, toe and heel angles and in several internal (radiographic) measurements including the widths and lengths of the phalanges and sesamoid bones as well as joint angles. Clinical Significance  Existing knowledge of distal limb development in foals, particularly the foot, is limited. These findings define the measurable changes of the foal foot as it grows during the first year of life. These data provide an insight into the transformation of the hoof from its initial oval to a circular shape and from a club-like, cylindrical conformation to a more angled, conical conformation. This paper quantifies this development, ultimately allowing a better understanding of morphological changes in the foot of the growing foal. Schattauer GmbH Stuttgart.

Early Pleistocene human hand phalanx from the Sima del Elefante (TE) cave site in Sierra de Atapuerca (Spain).

PubMed

Lorenzo, Carlos; Pablos, Adrián; Carretero, José Miguel; Huguet, Rosa; Valverdú, Josep; Martinón-Torres, María; Arsuaga, Juan Luis; Carbonell, Eudald; Bermúdez de Castro, José María

2015-01-01

In this study, a new Early Pleistocene proximal hand phalanx (ATE9-2) from the Sima del Elefante cave site (TE - Sierra de Atapuerca, Spain), ascribed to Homo sp., is presented and comparatively described in the context of the evolution of the genus Homo. The ATE9-2 specimen is especially important because of the paucity of hand bones in the human fossil record during the Early Pleistocene. The morphological and metrical analyses of the phalanx ATE9-2 indicate that there are no essential differences between it and comparator fossil specimens for the genus Homo after 1.3 Ma (millions of years ago). Similar to Sima de los Huesos and Neandertal specimens, ATE9-2 is a robust proximal hand phalanx, probably reflecting greater overall body robusticity in these populations or a higher gracility in modern humans. The age of level TE9 from Sima del Elefante and morphological and metrical studies of ATE9-2 suggest that the morphology of the proximal hand phalanges and, thus, the morphology of the hand could have remained stable over the last 1.2-1.3 Ma. Taking into account the evidence recently provided by a metacarpal from Kaitio (Kenya) from around 1.42 Ma, we argue that modern hand morphology is present in the genus Homo subsequent to Homo habilis. Copyright © 2014 Elsevier Ltd. All rights reserved.

Buried Versus Exposed Kirschner Wires Following Fixation of Hand Fractures: l Clinician and Patient Surveys.

PubMed

2018-04-01

Fractures of the metacarpals and phalanges are common. Placement of Kirschner wires (K-wires) is the most common form of surgical fixation. After placement, a key decision is whether to bury the end of a K-wire or leave it protruding from the skin (exposed). A recent systematic review found no evidence to support either approach. The aim of study was to investigate current clinical practice, understand the key factors influencing clinician decision-making, and explore patient preferences to inform the design of a randomized clinical trial. The steering group developed surveys for hand surgeons, hand therapists, and patients. Following piloting, they were distributed across the United Kingdom hand surgery units using the Reconstructive Surgery Trials Network. A total of 423 hand surgeons, 187 hand therapists, and 187 patients completed the surveys. Plastic surgeons and junior surgical trainees preferred to leave K-wires not buried. Ease of removal correlated with a decision to leave wires exposed, whereas perceived risk of infection correlated with burying wires. Cost did not affect the decision. Hand therapists were primarily concerned about infection and patient-related outcomes. Patients were most concerned about wire-related problems and pain. This national survey provides a new understanding of the use of K-wires to manage hand fractures in the United Kingdom. A number of nonevidence-based factors seem to influence the decision to bury or leave K-wires exposed. The choice has important clinical and health economic implications that justify a randomized controlled trial.

MDA5-Associated Neuroinflammation and the Singleton–Merten Syndrome: Two Faces of the Same Type I Interferonopathy Spectrum

PubMed Central

Buers, Insa; Rice, Gillian I.; Crow, Yanick J.

2017-01-01

In 1973, Singleton and Merten described a new syndrome in 2 female probands with aortic and cardiac valve calcifications, early loss of secondary dentition, and widened medullary cavities of the phalanges. In 1984, Aicardi and Goutières defined a phenotype resembling congenital viral infection with basal ganglia calcification and increased protein content in the cerebrospinal fluid. Between 2006 and 2012, mutations in 6 different genes were described to be associated with Aicardi–Goutières syndrome, specifically—TREX1, RNASEH2A, RNASEH2B, RNASEH2C, ADAR, and SAMHD1. More recently, mutations in IFIH1 were reported in a variety of neuroimmunological phenotypes, including Aicardi–Goutières syndrome, while a specific Arg822Gln mutation in IFIH1 was described in 3 discrete families with Singleton–Merten syndrome (SMS). IFIH1 encodes for melanoma differentiation-associated gene 5 (MDA5), and all mutations identified to date have been associated with an enhanced interferon response in affected individuals. In this study, we present a male child demonstrating recurrent febrile episodes, spasticity, and basal ganglia calcification suggestive of Aicardi–Goutières syndrome, who carries the same Arg822Gln mutation in IFIH1 previously associated with SMS. We conclude that both diseases are part of the interferonopathy grouping and that the Arg822Gln mutation in IFIH1 can cause a spectrum of disease, including neurological involvement. PMID:28475458

Accelerated bone mass senescence after hematopoietic stem cell transplantation.

PubMed

Serio, B; Pezzullo, L; Fontana, R; Annunziata, S; Rosamilio, R; Sessa, M; Giudice, V; Ferrara, I; Rocco, M; De Rosa, G; Ricci, P; Tauchmanovà, L; Montuori, N; Selleri, C

2013-01-01

Osteoporosis and avascular necrosis (AVN) are long-lasting and debilitating complications of hematopoietic stem cell transplantation (HSCT). We describe the magnitude of bone loss, AVN and impairment in osteogenic cell compartment following autologous (auto) and allogeneic (allo) HSCT, through the retrospective bone damage revaluation of 100 (50 auto- and 50 allo-HSCT) long-term survivors up to 15 years after transplant. Current treatment options for the management of these complications are also outlined. We found that auto- and allo-HSCT recipients show accelerated bone mineral loss and micro-architectural deterioration during the first years after transplant. Bone mass density (BMD) at the lumbar spine, but not at the femur neck, may improve in some patients after HSCT, suggesting more prolonged bone damage in cortical bone. Phalangeal BMD values remained low for even more years, suggesting persistent bone micro-architectural alterations after transplant. The incidence of AVN was higher in allo-HSCT recipients compared to auto-HSCT recipients. Steroid treatment length, but not its cumulative dose was associated with a higher incidence of bone loss. Allo-HSCT recipients affected by chronic graft versus host disease seem to be at greater risk of continuous bone loss and AVN development. Reduced BMD and higher incidence of AVN was partly related to a reduced regenerating capacity of the normal marrow osteogenic cell compartment. Our results suggest that all patients after auto-HSCT and allo-HSCT should be evaluated for their bone status and treated with anti-resorptive therapy as soon as abnormalities are detected.

Early Functional Treatment of Proximal Phalanx Fractures in Children: A Case Series Study.

PubMed

Bohr, Stefan; Mammadli, Toghrul

2018-05-23

The objective of this study was to assess proper indications a nonsurgical treatment regime for pediatric fractures of the proximal phalanx based on principles of early functional treatment. A case series (evidence level 4) of 30 pediatric patients with fractures of the proximal phalanx were treated nonsurgically using protective dynamic splinting techniques and fiberglass casting material. Assessments were performed clinically and by x-ray within 4 to 8 weeks of commencement of treatment. Outcome measures included Disabilities of the Arm, Shoulder, and Hand score questionnaire as well as fingertip palm distance (cm) and dynamic pain interval assessments. All fractures healed without any clinically apparent bony deformities. Disabilities of the Arm, Shoulder, and Hand scores were of 25.17 ± 5.29 (mean ± SD), which indicated good functional results usually within 2 weeks of removal of dynamic splints. Fingertip palm distance measurements at endpoints were of 0.17 ± 0.27 cm (mean ± SD), which indicated an almost free range of finger motion. Absence of pain perception under active finger motion (dynamic pain interval) was noted at 14.10 ± 6.79 days (mean ± SD). Well-established criteria for surgical treatment of phalangeal fractures exist. However, in our experience, a majority of pediatric fractures of the proximal phalanx can be safely treated nonsurgically with dynamic splinting along with shorter intervals of immobilization of the affected fingers and faster restoration of overall hand function compared to surgical treatment.

Hand injuries from snow blowers: a report of an epidemic.

PubMed

Tetz, D J; Aghababian, R

1995-01-01

During a record snowfall in Worcester, Massachusetts, 11-13 December 1992, 37 male patients with hand injuries suffered during snow blower operation were seen at three area hospitals. Two previous reports describe 13 patients seen over a 3-year period and 28 patients over a 12-year period. This report describes the largest number of hand injuries from snow blowers that have occurred over a 48-hour period. The snow was unusual because of the high water density in the initial 9 inches (23 cm) that fell at an average temperature of 33 degrees F (0.6 degree C) with the final depth of 30 inches (76 cm), causing the machines to become clogged. Patients admitted to reaching into a running machine in 35/37 (95%) cases, 11/37 (30%) claimed the auger and impeller blades were disengaged, and 2/37 (5%) patients claimed their injuries occurred with the engines turned off. All injuries occurred when the patients placed their hands down the chute, contacting the impeller blades. Injuries involved 32 long, 15 ring, 13 index, and five small fingers and ranged from simple lacerations to partial phalangeal amputations. The majority, 27/37 (73%), were managed in emergency departments without interventions in the operating suites. Infection occurred in one patient who had the lesion repaired in the operating suite. As in previous studies, no differences were found for the variables of snow-blower age, type, or horsepower, or on experience level or age of the operators.(ABSTRACT TRUNCATED AT 250 WORDS)

The Influence of Eye Closure on Somatosensory Discrimination: A Trade-off Between Simple Perception and Discrimination.

PubMed

Götz, Theresa; Hanke, David; Huonker, Ralph; Weiss, Thomas; Klingner, Carsten; Brodoehl, Stefan; Baumbach, Philipp; Witte, Otto W

2017-06-01

We often close our eyes to improve perception. Recent results have shown a decrease of perception thresholds accompanied by an increase in somatosensory activity after eye closure. However, does somatosensory spatial discrimination also benefit from eye closure? We previously showed that spatial discrimination is accompanied by a reduction of somatosensory activity. Using magnetoencephalography, we analyzed the magnitude of primary somatosensory (somatosensory P50m) and primary auditory activity (auditory P50m) during a one-back discrimination task in 21 healthy volunteers. In complete darkness, participants were requested to pay attention to either the somatosensory or auditory stimulation and asked to open or close their eyes every 6.5 min. Somatosensory P50m was reduced during a task requiring the distinguishing of stimulus location changes at the distal phalanges of different fingers. The somatosensory P50m was further reduced and detection performance was higher during eyes open. A similar reduction was found for the auditory P50m during a task requiring the distinguishing of changing tones. The function of eye closure is more than controlling visual input. It might be advantageous for perception because it is an effective way to reduce interference from other modalities, but disadvantageous for spatial discrimination because it requires at least one top-down processing stage. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Knock-in human GDF5 proregion L373R mutation as a mouse model for proximal symphalangism.

PubMed

Zhang, Xinxin; Xing, Xuesha; Liu, Xing; Hu, Yu; Qu, Shengqiang; Wang, Heyi; Luo, Yang

2017-12-26

Proximal symphalangism (SYM1) is an autosomal dominant disorder, mainly characterized by bony fusions of the proximal phalanges of the hands and feet. GDF5 and NOG were identified to be responsible for SYM1. We have previously reported on a p.Leu373Arg mutation in the GDF5 proregion present in a Chinese family with SYM1. Here, we investigated the effects of the GDF-L373R mutation. The variant caused proteolysis efficiency of GDF5 increased in ATDC5 cells. The variant also caused upregulation of SMAD1/5/8 phosphorylation and increased expression of target genes SMURF1 , along with COL2A1 and SOX9 which are factors associated with chondrosis. Furthermore, we developed a human-relevant SYM1 mouse model by making a Gdf5 L367R (the orthologous position for L373R in humans) knock-in mouse. Gdf5 L367R/+ and Gdf5 L367R/L367R mice displayed stiffness and adhesions across the proximal phalanx joint which were in complete accord with SYM1. It was also confirmed the joint formation and development was abnormal in Gdf5 L367R/+ and Gdf5 L367R/L367R mice, including the failure to develop the primary ossification center and be hypertrophic chondrocytes during embryonic development. This knock-in mouse model offers a tool for assessing the pathogenesis of SYM1 and the function of the GDF5 proregion.

Content-based image retrieval applied to bone age assessment

NASA Astrophysics Data System (ADS)

Fischer, Benedikt; Brosig, André; Welter, Petra; Grouls, Christoph; Günther, Rolf W.; Deserno, Thomas M.

2010-03-01

Radiological bone age assessment is based on local image regions of interest (ROI), such as the epiphysis or the area of carpal bones. These are compared to a standardized reference and scores determining the skeletal maturity are calculated. For computer-aided diagnosis, automatic ROI extraction and analysis is done so far mainly by heuristic approaches. Due to high variations in the imaged biological material and differences in age, gender and ethnic origin, automatic analysis is difficult and frequently requires manual interactions. On the contrary, epiphyseal regions (eROIs) can be compared to previous cases with known age by content-based image retrieval (CBIR). This requires a sufficient number of cases with reliable positioning of the eROI centers. In this first approach to bone age assessment by CBIR, we conduct leaving-oneout experiments on 1,102 left hand radiographs and 15,428 metacarpal and phalangeal eROIs from the USC hand atlas. The similarity of the eROIs is assessed by cross-correlation of 16x16 scaled eROIs. The effects of the number of eROIs, two age computation methods as well as the number of considered CBIR references are analyzed. The best results yield an error rate of 1.16 years and a standard deviation of 0.85 years. As the appearance of the hand varies naturally by up to two years, these results clearly demonstrate the applicability of the CBIR approach for bone age estimation.

Brachdactyly Instigated as a Result of Mutation in GDF5 and NOG Genes in Pakistani Population.

PubMed

Khan, Samiullah; Mudassir, Muhammad; Khan, Naqab; Marwat, Asmatullah

2018-01-01

Brachdactyly a genetic disorder associated with the abnormal development of metacarpals, phalanges or both which results in the shortening of hands and feet. Mutations in the contributing genes has been recognized with the majority of the investigated syndromic form of brachdactyly. The current study was proposed to examine mutation in NOG and GDF5 genes in a Pakistani family. Poly Acrylamide Gel Electrophoresis and Polymerase Chain Reaction was used for the genomic screening and linkage analysis to observe the mutation in genes. The samples were collected from Luckki Marwat district, KPK, while the research study was conducted in the department of Biochemistry, Quaid-I-Azam University, Islamabad, Pakistan. After survey, family was identified with brachdactyly type A2 and investigated a heterozygous arginine to glutamine exchange in the growth demarcation factor 5 in all the victim persons. Different types of skeletal dysplasia resulted due to mutation in the GDF5 genes. Novel GDF5 genes mutations were reported with distinct limb malformation and sequencing of coding region revealed that the mildly affected individuals were heterozygous while the harshly affected individuals were homozygous. The current study reported the genetic variability and concluded that the Brachdacytyly type A2 and type B2 resulted due to mutation in GDF5 and NOG genes respectively. A new subtype of brachydactyly (BDB2) was instigated as a result of novel mutations in NOG. The mutation has been reported for the first time in Pakistani population and especially in Pushtoon ethnic population.

Paleoecological reconstruction of hominin-bearing middle Pliocene localities at Woranso-Mille, Ethiopia.

PubMed

Curran, Sabrina C; Haile-Selassie, Yohannes

2016-07-01

Woranso-Mille is a paleoanthropological site in Ethiopia sampling an important and under-represented time period in human evolution (3.8-3.6 million years ago). Specimens of cf. Australopithecus anamensis, Australopithecus afarensis, and the recently named Australopithecus deyiremeda have been recovered from this site. Using multiple habitat proxies, this study provides a paleoecological reconstruction of two fossiliferous collection areas from Woranso-Mille, Aralee Issie (ARI) and Mesgid Dora (MSD). Previous reconstructions based on faunal assemblages have pointed, due to the presence of aepycerotins, alcelaphins, and proboscideans, to the existence of open habitats as well as more closed ones, based on the occurrence of cercopithecids, giraffids, and traglephins. Results from community structure analysis (proportions of locomotor and dietary adaptations) at ARI and MSD indicated a predominance of open habitats, such as shrublands. Mesowear analysis revealed that ungulates of all dietary types (grazers, leaf and fruit browsers, and mixed feeders) were present in nearly equal proportions. Ecomorphological analyses using linear measurements of the astragalus and phalanges indicated that bovids utilizing locomotor behaviors associated with all habitat types were present, though the intermediate-cover habitat bovids were best represented in the sample (Heavy cover at ARI and Light cover at MSD). Together, these results suggest that the ARI and MSD localities were heterogeneous habitats (mosaics), likely with densely vegetated areas along a paleo-river and more open regions (woodlands, grasslands) available away from the river. Copyright © 2016 Elsevier Ltd. All rights reserved.

Speed invariance of independent control of finger movements in pianists

PubMed Central

Soechting, John F.

2012-01-01

Independent control of finger movements characterizes skilled motor behaviors such as tool use and musical performance. The purpose of the present study was to identify the effect of movement frequency (tempo) on individuated finger movements in piano playing. Joint motion at the digits was recorded while 5 expert pianists were playing 30 excerpts from musical pieces with different fingering and key locations either at a predetermined normal tempo or as fast as possible. Principal component analysis and cluster analysis using an expectation-maximization algorithm determined three distinct patterns of finger movement coordination for a keypress with each of the index, middle, ring, and little fingers at each of the two tempi. The finger kinematics of each coordination pattern was overall similar across the tempi. Tone sequences assigned into each cluster were also similar for both tempi. A linear regression analysis determined no apparent difference in the amount of movement covariation between the striking and nonstriking fingers at both metacarpo-phalangeal and proximal-interphalangeal joints across the two tempi, which indicated no effect of tempo on independent finger movements in piano playing. In addition, the standard deviation of interkeystroke interval across strokes did not differ between the two tempi, indicating maintenance of rhythmic accuracy of keystrokes. Strong temporal constraints on finger movements during piano playing may underlie the maintained independent control of fingers over a wider range of tempi, a feature being likely to be specific to skilled pianists. PMID:22815403

Hunter-McAlpine craniosynostosis phenotype associated with skeletal anomalies and interstitial deletion of chromosome 17q

DOE Office of Scientific and Technical Information (OSTI.GOV)

Thomas, J.; Prescott, K.; Milner, R.

1994-09-01

Syndromic craniosynostosis is frequently associated with skeletal abnormalities, but the biological basis for this association is unclear. Molecular genetic studies have the biological basis for this association is unclear. Molecular genetic studies have identified a number of loci and at least one candidate gene, the MSX2 gene. We recently encountered a 9 y.o. boy with moderate mental retardation, congenital craniosynostosis, and multiple skeletal anomalies. Physical features strongly suggested Hunter-McAlpine syndrome (HMS). Specifically, he had triangular facies with a small mouth prominent chin, bulbous nose, thin vermillion border, malaligned and malformed teeth, and low set, rudimentary ears. Skeletal features included: bilambdoidal,more » bicoronal, and sagittal craniosynostosis; right preaxial polydactyly; bilateral talipes; coxa valga; genu valgum; bilateral fusion of the hamate and capitate; scoliosis; and small, irregular middle phalangeal epiphyses. High resolution chromosome analysis revealed an interstitial deletion of G negative material of subbands q23.1{r_arrow}23.3 or q23.3{r_arrow}q24.2 of a No. 17 homologue. HMS, a presumed autosomal dominant disorder associated with characteristic facies, variable degrees of mental retardation, craniosynostosis, and minor acral-skeletal anomalies, proved to be the most likely explanation for this patient`s findings. We propose that our patient has a new mutation for HMS with more severe skeletal involvement than previously reported. Linkage studies are in progress to test the hypothesis that familial HMS may be localized to chromosome 17.« less

[Digital gigantism of the foot: a clinical study of 12 cases].

PubMed

Wang, Hai-hua; Tian, Guang-lei; Zhu, Yin; Zhang, You-le; Zhao, Jun-hui; Tian, Wen

2008-03-15

To summarize the clinical characteristic and outcome of digital gigantism of the foot. Retrospectively analyze the clinical documents of cases of digital gigantism of the foot. Twelve 12 cases with 13 feet in this study included 8 male and 4 female with an average 4.6-years-old. All the deformities were found at birth. Multiple toes involved were more than single toe, and tibial toe involved more than fibular. Forefoot was enlarged. All the phalanges involved and partial metatarsal bones were enlarged. Marked increase in subcutaneous fat was found in all cases in the operation which infiltrated interossei and articular capsules. The appearance of the nerves and its branches in the foot were normal and fat infiltrating was not discovered. The operation types included debulking, epiphyseal arrest, amputation, nerve stripping and anastomosis. Seven cases were followed up with mean periods 25.6 months. Functional evaluation according to a criterion formulated by author revealed a result of 2 excellent, 2 good and 3 fair. Digital gigantism of the foot is an uncommon congenital deformity of the foot characterized by overgrowth of both the soft-tissue and the osseous elements of the enlarged toe and forefoot. Surgical treatment is the unique method, and the goal is to reduce the size of the foot to allow fitting regular shoes and walking readily. There are several types of operations which to be chosen. The indication, the timing of operative intervention and the selection of operation type should be paid more attention.

Epidermoid Cyst of Mandible Ramus: Case Report

PubMed Central

Loxha, Mergime Prekazi; Salihu, Sami; Kryeziu, Kaltrina; Loxha, Sadushe; Agani, Zana; Hamiti, Vjosa; Rexhepi, Aida

2016-01-01

Introduction: An epidermoid cyst is a benign cyst usually found on the skin. Bone cysts are very rare and if they appear in bone they usually appear in the distal phalanges of the fingers. Epidermoid cysts of the jaws are uncommon. Case presentation: We present a case, of a 41 year-old female patient admitted to our department because of pain and swelling in the parotid and masseteric region–left side. There was no trismus, pathological findings in skin, high body temperature level, infra-alveolar nerves anesthesia or lymphadenopathy present. The orthopantomography revealed a cystic lesion and a unilocular lesion that included mandibular ramus on the left side with 3 cm in diameter. Under total anesthesia, a cyst had been reached and was enucleated. Histopathologic findings showed that the pathologic lesion was an epidermoid cyst. Discussion: Epidermoid and dermoid cysts are rare, benign lesions found throughout the body. Only a few cases in literature describe an intraossesus epidermoid cyst. Conclusion: Our case is an epidermoid cyst with a rare location in the region of the mandibular ramus. It is not associated with any trauma in this region except medical history reveals there was an operative removal of a wisdom tooth 12 years ago in the same side. These cysts are interesting from the etiological point of view. They should be considered in the differential diagnosis of other radiolucent lesions of the jaws. Surgically they have a very good prognosis, and are non-aggressive lesions. PMID:27594757

Place of the reposition flap in the treatment of distal amputations of the fingers.

PubMed

Sbai, Mohamed Ali; M'chirgui, Mayssa El; Maalla, Riadh; Khorbi, Adel

2017-08-01

Distal finger amputations pose a therapeutic problem with the distal fragment quality. Reimplantation remains the reference treatment for functional and aesthetic recovery of the hand. The interest of this study is to propose the reposition flap as an alternative to different hedging techniques in the proximal stump, in many situations where revascularization is impossible. It consists in osteosynthesis of the bone fragment and its coverage by a pedicled local flap. The technique of reposition flap was evaluated retrospectively between 2003 and 2016 through a study of 13 patients compiled in Nabeul orthopedic department. For each patient, the sensitivity, the pulp trophicity, the interphalangeal mobility, the digital length, the appearance of the nail and radiological consolidation were evaluated. The reposition flap keeps more than 80% of the length of p3. This procedure improves nail aesthetics in comparison with the regularizations. There is no significant difference in sensitivity of the pulp or of the mobility of the distal inter-phalangeal (DIP) joint as a function of the technique studied. However there is a significant difference in average test of the Quick Dash (350 against 500 for regularizations). The reposition flap seems to be a good alternative to regularization in the context of trans-p3 fingers amputations, in which the distal fragment is not revascularizable. It allows better aesthetic and functional results. Copyright © 2017 Daping Hospital and the Research Institute of Surgery of the Third Military Medical University. Production and hosting by Elsevier B.V. All rights reserved.

Experimental Butchering of a Chimpanzee Carcass for Archaeological Purposes

PubMed Central

Saladié, Palmira; Cáceres, Isabel; Huguet, Rosa; Rodríguez-Hidalgo, Antonio; Santander, Borís; Ollé, Andreu; Gabucio, Mª Joana; Martín, Patricia; Marín, Juan

2015-01-01

Two archaeological assemblages from the Sierra de Atapuerca sites show evidence of anthropogenic cannibalism. These are the late Early Pleistocene level TD6-2 at Gran Dolina, and the Bronze Age level MIR4 in the Mirador Cave. Despite the chronological distance between these two assemblages, they share the common feature that the human remains exhibit a high frequency of anthropogenic modifications (cut marks, percussion pits and notches and peeling). This frequency could denote special treatment of bodies, or else be the normal result of the butchering process. In order to test these possibilities, we subjected a chimpanzee carcass to a butchering process. The processing was intensive and intended to simulate preparation for consumption. In doing this, we used several simple flakes made from quartzite and chert from quarries in the Sierra de Atapuerca. The skull, long bones, metapodials and phalanges were also fractured in order to remove the brain and bone marrow. As a result, about 40% of the remains showed some kind of human modification. The frequency, distribution and characteristics of these modifications are very similar to those documented on the remains of Homo antecessor from TD6-2. In case of the MIR4 assemblage, the results are similar except in the treatment of skulls. Our results indicate that high frequencies of anthropogenic modifications are common after an intensive butchering process intended to prepare a hominin body for consumption in different contexts (both where there was possible ritual behavior and where this was not the case and the modifications are not the result of special treatment). PMID:25793521

Novel Semiquantitative Bone Marrow Oedema Score and Fracture Score for the Magnetic Resonance Imaging Assessment of the Active Charcot Foot in Diabetes

PubMed Central

Meacock, L.; Donaldson, Ana; Isaac, A.; Briody, A.; Ramnarine, R.; Edmonds, M. E.; Elias, D. A.

2017-01-01

There are no accepted methods to grade bone marrow oedema (BMO) and fracture on magnetic resonance imaging (MRI) scans in Charcot osteoarthropathy. The aim was to devise semiquantitative BMO and fracture scores on foot and ankle MRI scans in diabetic patients with active osteoarthropathy and to assess the agreement in using these scores. Three radiologists assessed 45 scans (Siemens Avanto 1.5T, dedicated foot and ankle coil) and scored independently twenty-two bones (proximal phalanges, medial and lateral sesamoids, metatarsals, tarsals, distal tibial plafond, and medial and lateral malleoli) for BMO (0—no oedema, 1—oedema < 50% of bone volume, and 2—oedema > 50% of bone volume) and fracture (0—no fracture, 1—fracture, and 2—collapse/fragmentation). Interobserver agreement and intraobserver agreement were measured using multilevel modelling and intraclass correlation (ICC). The interobserver agreement for the total BMO and fracture scores was very good (ICC = 0.83, 95% confidence intervals (CI) 0.76, 0.91) and good (ICC = 0.62; 95% CI 0.48, 0.76), respectively. The intraobserver agreement for the total BMO and fracture scores was good (ICC = 0.78, 95% CI 0.6, 0.95) and fair to moderate (ICC = 0.44; 95% CI 0.14, 0.74), respectively. The proposed BMO and fracture scores are reliable and can be used to grade the extent of bone damage in the active Charcot foot. PMID:29230422

Determining early referral criteria for patients with suspected inflammatory arthritis presenting to primary care physicians: a cross-sectional study.

PubMed

Almoallim, Hani; Janoudi, Nahid; Attar, Suzan M; Garout, Mohammed; Algohary, Shereen; Siddiqui, Muhammad Irfanullah; Alosaimi, Hanan; Ibrahim, Ashraf; Badokhon, Amira; Algasemi, Zaki

2017-01-01

Early diagnosis and initiation of treatment for inflammatory arthritis can greatly improve patient outcome. We aimed to provide standardized and validated criteria for use by primary care physicians (PCPs) in the identification of individuals requiring referral to a rheumatologist. We analyzed the predictive value of a wide variety of demographic variables, patient-reported complaints, physical examination results, and biomarkers in order to identify the most useful factors for indicating a requirement for referral. Patients for this cross-sectional study were enrolled from various centers of the city of Jeddah, Saudi Arabia, if they were ≥18 years of age and presented to a PCP with small joint pain that had been present for more than 6 weeks. A total of 203 patients were enrolled, as indicated by the sample size calculation. Each patient underwent a standardized physical examination, which was subsequently compared to ultrasound findings. Biomarker analysis and a patient interview were also carried out. Results were then correlated with the final diagnosis made by a rheumatologist. A total of 9 variables were identified as having high specificity and good predictive value: loss of appetite, swelling of metacarpophalangeal joint 2 or 5, swelling of proximal inter-phalangeal joint 2 or 3, wrist swelling, wrist tenderness, a positive test for rheumatoid factor, and a positive test for anti-citrullinated protein antibodies. Nine variables should be the basis of early referral criteria. It should aid PCPs in making appropriate early referrals of patients with suspected inflammatory arthritis, accelerating diagnosis and initiation of treatment.

Multi-segment foot kinematics and ground reaction forces during gait of individuals with plantar fasciitis.

PubMed

Chang, Ryan; Rodrigues, Pedro A; Van Emmerik, Richard E A; Hamill, Joseph

2014-08-22

Clinically, plantar fasciitis (PF) is believed to be a result and/or prolonged by overpronation and excessive loading, but there is little biomechanical data to support this assertion. The purpose of this study was to determine the differences between healthy individuals and those with PF in (1) rearfoot motion, (2) medial forefoot motion, (3) first metatarsal phalangeal joint (FMPJ) motion, and (4) ground reaction forces (GRF). We recruited healthy (n=22) and chronic PF individuals (n=22, symptomatic over three months) of similar age, height, weight, and foot shape (p>0.05). Retro-reflective skin markers were fixed according to a multi-segment foot and shank model. Ground reaction forces and three dimensional kinematics of the shank, rearfoot, medial forefoot, and hallux segment were captured as individuals walked at 1.35 ms(-1). Despite similarities in foot anthropometrics, when compared to healthy individuals, individuals with PF exhibited significantly (p<0.05) (1) greater total rearfoot eversion, (2) greater forefoot plantar flexion at initial contact, (3) greater total sagittal plane forefoot motion, (4) greater maximum FMPJ dorsiflexion, and (5) decreased vertical GRF during propulsion. These data suggest that compared to healthy individuals, individuals with PF exhibit significant differences in foot kinematics and kinetics. Consistent with the theoretical injury mechanisms of PF, we found these individuals to have greater total rearfoot eversion and peak FMPJ dorsiflexion, which may put undue loads on the plantar fascia. Meanwhile, increased medial forefoot plantar flexion at initial contact and decreased propulsive GRF are suggestive of compensatory responses, perhaps to manage pain. Copyright © 2014 Elsevier Ltd. All rights reserved.

Bone mineral status and metabolism in patients with Williams-Beuren syndrome.

PubMed

Stagi, Stefano; Manoni, Cristina; Scalini, Perla; Chiarelli, Francesco; Verrotti, Alberto; Cecchi, Cecilia; Lapi, Elisabetta; Giglio, Sabrina; Romano, Silvia; de Martino, Maurizio

2016-07-01

To evaluate bone mineral status and metabolism in a cohort of patients with Williams-Beuren syndrome (WBS). Thirty-one children (15 females, 16 males; mean age 9.6±2.74 years) and 10 young adults (6 females, 4 males; mean age 21.4±5.11 years) with WBS were cross-sectionally evaluated and compared with two age-, sex-, and body-size-matched paediatric (155 subjects, 75 females and 80 males; mean age 9.7±2.93 years) and adult (50 subjects, 30 females and 20 males; mean age 22.3±5.42 years) healthy controls. We evaluated ionised and total calcium, phosphate, parathyroid hormone (PTH), 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, osteocalcin, bone alkaline phosphatase levels, and urinary deoxypyridinoline concentrations. We also calculated the phalangeal amplitude-dependent speed of sound (AD-SoS) and the bone transmission time (BTT) z-scores. WBS patients showed a significantly reduced AD-SoS z-score (p <0.001) and BTT z-score (p <0.001) compared with the controls. This finding persisted when we divided the sample into paediatric and adult patients. WBS patients also had significantly higher ionised (p <0.001) and total calcium (p <0.001) levels as well as higher PTH levels (p <0.001) compared with the controls. Furthermore, WBS children and adolescents had significantly lower serum osteocalcin levels (p <0.001) and urinary deoxypyridinoline concentrations (p <0.001) than controls. WBS subjects exhibit a significant reduction in bone mineral status and impaired bone metabolism. These findings point to the need for close monitoring of WBS patients.

Design and Fabrication of a Universal Soft Gripper

NASA Astrophysics Data System (ADS)

Sabzehzar, Amin

Inspired from nature, soft robots capable of actively tuning their mechanical rigidity can rapidly transition between a broad range of motor tasks, from lifting heavy loads to dexterous manipulation of delicate objects. Reversible rigidity tuning also enables soft robotic actuators to reroute their internal loading and alter their mode of deformation in response to intrinsic activation. In this study, we demonstrate this principle with a three-fingered pneumatic gripper that contains programmable ligaments that change stiness when activated with electrical current. The ligaments are composed of a conductive thermoplastic elastomer composite that reversibly softens under resistive heating. Depending on which ligaments are activated, the gripper will bend inward to pick up an object, bend laterally to twist it, or bend outward to release it. Each finger consists of three PDMS phalanges that are attached with two Ecoflex joints. Three ligaments (strips of a cPBE-PDMS composite layer) are attached along the finger and are stimulated with electricity individually. When the high pressure air is injected in the hollow middle part of the finger, the finger will be bent in the opposite direction of the stimulated cPBE-PDMS element (softer wall). This enables the gripper's fingers to grab and twist objects with dierent sizes and shapes. All of the gripper motions are generated with a single pneumatic source of pressure and are controlled with an electrical board. The ability to incorporate electrically programmable ligaments in pneumatic or hydraulic actuators has the potential to enhance versatility and reduce dependency on tubing and valves. In this study, an activation/deactivation cycle can be completed within 15 s.

Preaxial Polydactyly in Sost/Sostdc1 Double Knockouts

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yee, C M; Collette, N M; Loots, G G

2011-07-29

In the United States, {approx}5% are born with congenital birth defects due to abnormal function of cellular processes and interactions. Sclerosteosis, a rare autosomal recessive disease, causes hyperostosis of the axial and appendicular skeleton, and patients present radial deviation, digit syndactyly, nail dysplasia, and overall high bone mineral density. Sclerosteosis is due to a loss of function of sclerostin (Sost). Sost is a Wnt (abbrev.) antagonist; when mutated, nonfunctional Sost results in hyperactive osteoblast activity which leads to abnormal high bone mass. Previous studies have shown that Sost overexpression in transgenic mice causes reduced bone mineral density and a varietymore » of limb phenotypes ranging from lost, fused, and split phalanges. Consistent with clinical manifestations of Sclerosteosis, Sost knockout mice exhibit increased generalized bone mineral density and syndactyly of the digits. Sostdc1 is a paralog of Sost that has also been described as an antagonist of Wnt signaling, in developing tooth buds. Unlike Sost knockouts, Sostdc1 null mice do not display any limb abnormalities. To determine if Sost and Sostdc1 have redundant functions during limb patterning, we examined Sost; Sostdc1 mice determined that they exhibit a novel preaxial polydactyly phenotype with a low penetrance. LacZ staining, skeletal preparations, and in situ hybridization experiments were used to help characterize this novel phenotype and understand how this phenotype develops. We find Sost and Sostdc1 to have complementary expression patterns during limb development, and the loss of their expression alters the transcription of several key limb regulators, such as Fgf8, Shh and Grem.« less

Thumbs down: a molecular-morphogenetic approach to avian digit homology.

PubMed

Capek, Daniel; Metscher, Brian D; Müller, Gerd B

2014-01-01

Avian forelimb digit homology remains one of the standard themes in comparative biology and EvoDevo research. In order to resolve the apparent contradictions between embryological and paleontological evidence a variety of hypotheses have been presented in recent years. The proposals range from excluding birds from the dinosaur clade, to assignments of homology by different criteria, or even assuming a hexadactyl tetrapod limb ground state. At present two approaches prevail: the frame shift hypothesis and the pyramid reduction hypothesis. While the former postulates a homeotic shift of digit identities, the latter argues for a gradual bilateral reduction of phalanges and digits. Here we present a new model that integrates elements from both hypotheses with the existing experimental and fossil evidence. We start from the main feature common to both earlier concepts, the initiating ontogenetic event: reduction and loss of the anterior-most digit. It is proposed that a concerted mechanism of molecular regulation and developmental mechanics is capable of shifting the boundaries of hoxD expression in embryonic forelimb buds as well as changing the digit phenotypes. Based on a distinction between positional (topological) and compositional (phenotypic) homology criteria, we argue that the identity of the avian digits is II, III, IV, despite a partially altered phenotype. Finally, we introduce an alternative digit reduction scheme that reconciles the current fossil evidence with the presented molecular-morphogenetic model. Our approach identifies specific experiments that allow to test whether gene expression can be shifted and digit phenotypes can be altered by induced digit loss or digit gain. © 2013 Wiley Periodicals, Inc.

Conditional inactivation of Has2 reveals a crucial role for hyaluronan in skeletal growth, patterning, chondrocyte maturation and joint formation in the developing limb.

PubMed

Matsumoto, Kazu; Li, Yingcui; Jakuba, Caroline; Sugiyama, Yoshinori; Sayo, Tetsuya; Okuno, Misako; Dealy, Caroline N; Toole, Bryan P; Takeda, Junji; Yamaguchi, Yu; Kosher, Robert A

2009-08-01

The glycosaminoglycan hyaluronan (HA) is a structural component of extracellular matrices and also interacts with cell surface receptors to directly influence cell behavior. To explore functions of HA in limb skeletal development, we conditionally inactivated the gene for HA synthase 2, Has2, in limb bud mesoderm using mice that harbor a floxed allele of Has2 and mice carrying a limb mesoderm-specific Prx1-Cre transgene. The skeletal elements of Has2-deficient limbs are severely shortened, indicating that HA is essential for normal longitudinal growth of all limb skeletal elements. Proximal phalanges are duplicated in Has2 mutant limbs indicating an involvement of HA in patterning specific portions of the digits. The growth plates of Has2-deficient skeletal elements are severely abnormal and disorganized, with a decrease in the deposition of aggrecan in the matrix and a disruption in normal columnar cellular relationships. Furthermore, there is a striking reduction in the number of hypertrophic chondrocytes and in the expression domains of markers of hypertrophic differentiation in the mutant growth plates, indicating that HA is necessary for the normal progression of chondrocyte maturation. In addition, secondary ossification centers do not form in the central regions of Has2 mutant growth plates owing to a failure of hypertrophic differentiation. In addition to skeletal defects, the formation of synovial joint cavities is defective in Has2-deficient limbs. Taken together, our results demonstrate that HA has a crucial role in skeletal growth, patterning, chondrocyte maturation and synovial joint formation in the developing limb.

High‐resolution ultrasonography of the first metatarsal phalangeal joint in gout: a controlled study

PubMed Central

Wright, Stephen A; Filippucci, Emilio; McVeigh, Claire; Grey, Arthur; McCarron, Maura; Grassi, Walter; Wright, Gary D; Taggart, Allister J

2007-01-01

Objective To compare high‐resolution ultrasound (HRUS) with conventional radiography in the detection of erosions in the first metatarsophalangeal joints (1st MTPJs) of patients with gout and to identify the characteristic sonographic features of gout. Methods HRUS examination of the 1st MTPJs of both feet was performed by two independent sonographers. The presence of joint and soft‐tissue pathology was recorded. x Ray examination of the feet was performed on the same day and reported by the same radiologist. Results 39 male patients with gout and 22 age‐matched control subjects (14 with an inflammatory arthropathy and 8 disease free) were studied. The agreement on erosion between HRUS and x ray was poor, κ = 0.229 (non‐weighted), with McNemar's test being significant (p<0.001) indicating a large number of false negative x rays. 22 MTPJs in patients with gout had never been subjected to a clinical attack of acute gout. In these MTPJs, there were 10 erosions detected by HRUS and 3 erosions on x ray. HRUS features significantly more prevalent in the patients with gout were hard and soft tophus‐like lesions (p<0.01) and the double contour sign (p<0.01). Conclusions These data show that HRUS may assist in the management of gout in two ways: first, by aiding in the diagnosis by identifying the sonographic features that may be representative of the disease, and, second, by allowing the early detection of erosive joint damage and/or tophaceous deposits even in clinically silent joints. PMID:17185326

Xylopia aethiopica (Annonaceae) fruit extract suppresses Freund's adjuvant-induced arthritis in Sprague-Dawley rats.

PubMed

Obiri, David D; Osafo, Newman; Ayande, Patrick G; Antwi, Aaron O

2014-03-28

Xylopia aethiopica is used in a decoction of the dried fruit to treat bronchitis, asthma, arthritis, rheumatism, headache, neuralgia and colic pain. The aim of the study is to evaluate the anti-arthritic effects of a 70% aqueous ethanol extract of the fruit of Xylopia aethiopica in a chronic inflammatory model. Adjuvant arthritis was induced in Sprague-Dawley rats by intraplantar injection of Complete Freund's adjuvant into the right hind paw. Foot volume was measured by water displacement plethysmometry. The oedema component of inflammation was evaluated as the percentage change in paw swelling and the total oedema induced calculated as area under the time course curves. In addition to X-ray radiography, histopathology of ankle joints supported by haematological analysis was used to assess the anti-arthritic action of the extract of Xylopia aethiopica (XAE). Xylopia aethiopica extract (100, 300 and 600 mg kg(-1)) modified the time course curve significantly reducing hind paw oedema in the ipsilateral paw at all dose levels when administered both prophylactically and therapeutically. In addition XAE significantly suppressed the systemic spread of the arthritis from the ipsilateral to the contralateral limbs. The radiological pictures of the joints particularly metatarsal, phalanges and the ankle joint space of rats in the XAE-treated group showed protective effect against adjuvant-induced arthritis while histopathology revealed significant reduction in mononuclear infiltration, pannus formation and bone erosion. The haematological analysis in the test animals revealed significant improvement relative to the CFA model group. Xylopia aethiopica XAE suppresses joint inflammation and destruction in arthritic rats. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

ALTERED PHALANX FORCE DIRECTION DURING POWER GRIP FOLLOWING STROKE

PubMed Central

Enders, Leah R.

2015-01-01

Many stroke survivors with severe impairment can grasp only with a power grip. Yet, little knowledge is available on altered power grip after stroke, other than reduced power grip strength. This study characterized stroke survivors’ static power grip during 100% and 50% maximum grip. Each phalanx force’s angular deviation from the normal direction and its contribution to total normal force was compared for 11 stroke survivors and 11 age-matched controls. Muscle activities and skin coefficient of friction (COF) were additionally compared for another 20 stroke and 13 age-matched control subjects. The main finding was that stroke survivors gripped with a 34% greater phalanx force angular deviation of 19±2° compared to controls of 14±1° (p<.05). Stroke survivors’ phalanx force angular deviation was closer to the 23° threshold of slippage between the phalanx and grip surface, which may explain increased likelihood of object dropping in stroke survivors. In addition, this altered phalanx force direction decreases normal grip force by tilting the force vector, indicating a partial role of phalanx force angular deviation in reduced grip strength post stroke. Greater phalanx force angular deviation may biomechanically result from more severe underactivation of stroke survivors’ first dorsal interosseous (FDI) and extensor digitorum communis (EDC) muscles compared to their flexor digitorum superficialis (FDS) or somatosensory deficit. While stroke survivors’ maximum power grip strength was approximately half of the controls’, the distribution of their remaining strength over the fingers and phalanges did not differ, indicating evenly distributed grip force reduction over the entire hand. PMID:25795079

Is Greulich and Pyle atlas still a good reference for bone age assessment?

NASA Astrophysics Data System (ADS)

Zhang, Aifeng; Tsao, Sinchai; Sayre, James W.; Gertych, Arkadiusz; Liu, Brent J.; Huang, H. K.

2007-03-01

The most commonly used method for bone age assessment in clinical practice is the book atlas matching method developed by Greulich and Pyle in the 1950s. Due to changes in both population diversity and nutrition in the United States, this atlas may no longer be a good reference. An updated data set becomes crucial to improve the bone age assessment process. Therefore, a digital hand atlas was built with 1,100 children hand images, along with patient information and radiologists' readings, of normal Caucasian (CAU), African American (BLK), Hispanic (HIS), and Asian (ASI) males (M) and females (F) with ages ranging from 0 - 18 years. This data was collected from Childrens' Hospital Los Angeles. A computer-aided-diagnosis (CAD) method has been developed based on features extracted from phalangeal regions of interest (ROIs) and carpal bone ROIs from this digital hand atlas. Using the data collected along with the Greulich and Pyle Atlas-based readings and CAD results, this paper addresses this question: "Do different ethnicities and gender have different bone growth patterns?" To help with data analysis, a novel web-based visualization tool was developed to demonstrate bone growth diversity amongst differing gender and ethnic groups using data collected from the Digital Atlas. The application effectively demonstrates a discrepancy of bone growth pattern amongst different populations based on race and gender. It also has the capability of helping a radiologist determine the normality of skeletal development of a particular patient by visualizing his or her chronological age, radiologist reading, and CAD assessed bone age relative to the accuracy of the P&G method.

Hands of early primates.

PubMed

Boyer, Doug M; Yapuncich, Gabriel S; Chester, Stephen G B; Bloch, Jonathan I; Godinot, Marc

2013-12-01

Questions surrounding the origin and early evolution of primates continue to be the subject of debate. Though anatomy of the skull and inferred dietary shifts are often the focus, detailed studies of postcrania and inferred locomotor capabilities can also provide crucial data that advance understanding of transitions in early primate evolution. In particular, the hand skeleton includes characteristics thought to reflect foraging, locomotion, and posture. Here we review what is known about the early evolution of primate hands from a comparative perspective that incorporates data from the fossil record. Additionally, we provide new comparative data and documentation of skeletal morphology for Paleogene plesiadapiforms, notharctines, cercamoniines, adapines, and omomyiforms. Finally, we discuss implications of these data for understanding locomotor transitions during the origin and early evolutionary history of primates. Known plesiadapiform species cannot be differentiated from extant primates based on either intrinsic hand proportions or hand-to-body size proportions. Nonetheless, the presence of claws and a different metacarpophalangeal [corrected] joint form in plesiadapiforms indicate different grasping mechanics. Notharctines and cercamoniines have intrinsic hand proportions with extremely elongated proximal phalanges and digit rays relative to metacarpals, resembling tarsiers and galagos. But their hand-to-body size proportions are typical of many extant primates (unlike those of tarsiers, and possibly Teilhardina, which have extremely large hands). Non-adapine adapiforms and omomyids exhibit additional carpal features suggesting more limited dorsiflexion, greater ulnar deviation, and a more habitually divergent pollex than observed plesiadapiforms. Together, features differentiating adapiforms and omomyiforms from plesiadapiforms indicate increased reliance on vertical prehensile-clinging and grasp-leaping, possibly in combination with predatory behaviors in ancestral euprimates. Copyright © 2013 Wiley Periodicals, Inc.

Diabetes and Obesity as Independent Risk Factors for Osteoporosis: Updated Results from the ROIS/EMEROS Registry in a Population of Five Thousand Post-Menopausal Women Living in a Region Characterized by Heavy Environmental Pressure.

PubMed

Neglia, Cosimo; Argentiero, Alberto; Chitano, Giovanna; Agnello, Nadia; Ciccarese, Roberta; Vigilanza, Antonella; Pantile, Valerio; Argentiero, Domenico; Quarta, Raffaele; Rivezzi, Matteo; Di Tanna, Gian Luca; Di Somma, Carolina; Migliore, Alberto; Iolascon, Giovanni; Gimigliano, Francesca; Distante, Alessandro; Piscitelli, Prisco

2016-11-01

Objectives : We aimed to analyze bone mineralization and the effect of different risk factors for osteoporosis in postmenopausal women. Methods : We found 4909 postmenopausal subjects within ≥10,000 records from the ROIS/EMEROS (Ionian and Salento Osteoporosis Registry/Euro Mediterranean Registry of Osteoporosis) registry, a population study carried out in an area characterized by heavy environmental pressure between Brindisi and Taranto from 2009 to 2016. All subjects were assessed via phalangeal quantitative ultrasound (QUS) to evaluate their bone mineralization (assessed via amplitude dependent speed of sound (AD-SoS)) and the association between demineralization and the presence of other conditions or risk factors. Results : Mean age was 64 ± 9.5 years and mean body mass index (BMI) was 28.7 ± 3.5 kg/m². Pearson correlation analyses revealed a negative association between bone mineralization (AD-SoS) and BMI ( p < 0.001). By using multivariate logistic regression analysis, we observed significant values of odds ratios (ORs) of osteoporosis (adjusted for age, physical activity, and the use of drugs known to increase the risk of fractures) in subjects with diabetes and obesity: 1.39 (confidence interval (CI): 1.05-1.83) and 1.46 (CI: 1.20-1.78), respectively. A statistically significant linear trend of higher ORs of osteoporosis was found for increasing values of BMI. Conclusions : Our study confirmed the high impact of obesity and type 1 and type 2 diabetes on osteoporosis.

Diabetes and Obesity as Independent Risk Factors for Osteoporosis: Updated Results from the ROIS/EMEROS Registry in a Population of Five Thousand Post-Menopausal Women Living in a Region Characterized by Heavy Environmental Pressure

PubMed Central

Neglia, Cosimo; Argentiero, Alberto; Chitano, Giovanna; Agnello, Nadia; Ciccarese, Roberta; Vigilanza, Antonella; Pantile, Valerio; Argentiero, Domenico; Quarta, Raffaele; Rivezzi, Matteo; Di Tanna, Gian Luca; Di Somma, Carolina; Migliore, Alberto; Iolascon, Giovanni; Gimigliano, Francesca; Distante, Alessandro; Piscitelli, Prisco

2016-01-01

Objectives: We aimed to analyze bone mineralization and the effect of different risk factors for osteoporosis in postmenopausal women. Methods: We found 4909 postmenopausal subjects within ≥10,000 records from the ROIS/EMEROS (Ionian and Salento Osteoporosis Registry/Euro Mediterranean Registry of Osteoporosis) registry, a population study carried out in an area characterized by heavy environmental pressure between Brindisi and Taranto from 2009 to 2016. All subjects were assessed via phalangeal quantitative ultrasound (QUS) to evaluate their bone mineralization (assessed via amplitude dependent speed of sound (AD-SoS)) and the association between demineralization and the presence of other conditions or risk factors. Results: Mean age was 64 ± 9.5 years and mean body mass index (BMI) was 28.7 ± 3.5 kg/m2. Pearson correlation analyses revealed a negative association between bone mineralization (AD-SoS) and BMI (p < 0.001). By using multivariate logistic regression analysis, we observed significant values of odds ratios (ORs) of osteoporosis (adjusted for age, physical activity, and the use of drugs known to increase the risk of fractures) in subjects with diabetes and obesity: 1.39 (confidence interval (CI): 1.05–1.83) and 1.46 (CI: 1.20–1.78), respectively. A statistically significant linear trend of higher ORs of osteoporosis was found for increasing values of BMI. Conclusions: Our study confirmed the high impact of obesity and type 1 and type 2 diabetes on osteoporosis. PMID:27809297

Wear studies of all UHMWPE couples under various bio-tribological conditions.

PubMed

Joyce, T J; Unsworth, A

2004-01-01

Wear tests were undertaken in which ultra high molecular weight polyethylene (UHMWPE) was rubbed against itself. Tests primarily employed a pin-on-plate wear test machine, with distilled water, Ringer solution and dilute bovine serum being used as the lubricants. Loads of 10N and 40N were employed, and some test pins had a rotational motion added. In all cases wear was high, with mean wear factors of up to 91 10 -6 mm3/Nm being measured, but the addition of rotation reduced the amount of material worn from the test plates. In the presence of bovine serum and under reciprocation only, pin wear was relatively low. With bovine serum as the lubricant, total mean wear factors for the UHMWPE couples were calculated to be in the range of 35 to 58 10-6mm3/Nm. Therefore the pin-on-plate tests showed that the choice of lubricant as well as the motion applied to the test pin had a significant influence on the wear volumes measured. A two-piece UHMWPE 'prosthesis' with matching hemispherical faces was fabricated and tested on a finger simulator. Distilled water was used as the lubricant and wear factors were found to be greater for the metacarpal component, 21 10 -6mm3/Nm, than the phalangeal component, 3 10-6mm3/Nm, after ten million cycles of testing. This result paralleled the greater wear seen by the plate than by the pin in the pin-on-plate tests under reciprocating motion. (Journal of Applied Biomaterials & Biomechanics 2004; 2: 29-34).

Modified toe pulp fillet flap coverage: Better wound healing and satisfactory length preservation.

PubMed

Baek, Sang Oon; Suh, Hyo Wan; Lee, Jun Yong

2018-01-01

Amputation is commonly performed for toe necrosis secondary to peripheral vascular diseases, such as diabetes mellitus. When amputating a necrotic toe, preservation of the bony structure is important for preventing the collapse of adjacent digits into the amputated space. However, in the popular terminal Syme's amputation technique, partial amputation of the distal phalanx could cause increased tension on the wound margin. Herein, we introduce a new way to resect sufficient bony structure while maintaining the normal length, based on a morphological analysis of the toes. Unlike the pulp of the finger in the distal phalanx, the toe has abundant teardrop-shaped pulp tissue. The ratio of the vertical length to the longitudinal length in the distal phalanx was compared between the toes and fingers. Amputation was performed at the proximal interphalangeal joint level. Then, a mobilizable pulp flap was rotated 90° cephalad to replace the distal soft tissue defect. This modified toe fillet flap was performed in 5 patients. The toe pulp was found to have a vertically oriented morphology compared to that of the fingers, enabling length preservation through cephalad rotation. All defects were successfully covered without marginal ischemia. While conventional toe fillet flap coverage focuses on the principle of length preservation as the first priority, our modified method takes both wound healing and length into account. The fattiest part of the pulp is advanced to the toe tip, providing a cushioning effect and enough length to substitute for phalangeal bone loss. Our modified method led to satisfactory functional and aesthetic outcomes.

Constitutional bone impairment in Noonan syndrome.

PubMed

Baldassarre, Giuseppina; Mussa, Alessandro; Carli, Diana; Molinatto, Cristina; Ferrero, Giovanni Battista

2017-03-01

Noonan syndrome (NS) is an autosomal dominant trait characterized by genotypic and phenotypic variability. It belongs to the Ras/MAPK pathway disorders collectively named Rasopathies or neurocardiofaciocutaneous syndromes. Phenotype is characterized by short stature, congenital heart defects, facial dysmorphisms, skeletal and ectodermal anomalies, cryptorchidism, mild to moderate developmental delay/learning disability, and tumor predisposition. Short stature and skeletal dysmorphisms are almost constant and several studies hypothesized a role for the RAS pathway in regulating bone metabolism. In this study, we investigated the bone quality assessed by phalangeal quantitative ultrasound (QUS) and the metabolic bone profiling in a group of patients with NS, to determine whether low bone mineralization is primary or secondary to NS characteristics. Thirty-five patients were enrolled, including 20 males (55.6%) and 15 females (44.5%) aged 1.0-17.8 years (mean 6.4 ± 4.5, median 4.9 years). Each patients was submitted to clinical examination, estimation of the bone age, laboratory assays, and QUS assessment. Twenty-five percent of the cohort shows reduced QUS values for their age based on bone transmission time. Bone measurement were adjusted for multiple factors frequently observed in NS patients, such as growth retardation, delayed bone age, retarded puberty, and reduced body mass index, potentially affecting bone quality or its appraisal. In spite of the correction attempts, QUS measurement indicates that bone impairment persists in nearly 15% of the cohort studied. Our results indicate that bone impairment in NS is likely primary and not secondary to any of the phenotypic traits of NS, nor consistent with metabolic disturbances. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Effects of perfluorooctanoic acid (PFOA) exposure to pregnant mice on reproduction.

PubMed

Yahia, Doha; El-Nasser, Mahmoud Abd; Abedel-Latif, Manal; Tsukuba, Chiaki; Yoshida, Midori; Sato, Itaru; Tsuda, Shuji

2010-08-01

Perfluorooctanoic acid (PFOA) has similar characteristics to perfluorooctane sulfonate (PFOS) in reproduction toxicity featured by neonatal death. We found that PFOS exposure to mice during pregnancy led to intracranial blood vessel dilatation of fetuses accompanied by severe lung collapse which caused neonatal mortality. Thus, we adopted the corresponding experimental design to PFOS in order to characterize the neonatal death by PFOA. Pregnant ICR mice were given 1, 5 and 10 mg/kg PFOA daily by gavage from gestational day (GD) 0 to 17 and 18 for prenatal and postnatal evaluations, respectively. Five to nine dams per group were sacrificed on GD 18 for prenatal evaluation; other 10 dams were left to give birth. No maternal death was observed. The liver weight increased dose-dependently, with hepatocellular hypertrophy, necrosis, increased mitosis and mild calcification at 10 mg/kg. PFOA at 10 mg/kg increased serum enzyme activities (GGT, ALT, AST and ALP) with hypoproteinemia and hypolipidemia. PFOA treatment reduced the fetal body weight at 5 and 10 mg/kg. Teratological evaluation showed delayed ossification of the sternum and phalanges and delayed eruption of incisors at 10 mg/kg, but did not show intracranial blood vessel dilatation. Postnatal evaluation revealed that PFOA reduced the neonatal survival rate at 5 and 10 mg/kg. At 5 mg/kg pups were born alive and active and 16% died within 4 days observation, while all died within 6 hr after birth at 10 mg/kg without showing intracranial blood vessel dilatation. The cause of neonatal death by PFOA may be different from PFOS.

[Study of mechanical effects of the EVA glove on finger base with finite element modeling].

PubMed

Li, Zhuoyou; Ding, Li; Yue, Guodong

2013-08-01

The hand strength of astronauts, when they are outside the space capsule, is highly influenced by the residual pressure (the pressure difference between inside pressure and outside one of the suit) of extravehicular activity spacesuit glove and the pressure exerted by braided fabric. The hand strength decreases significantly on extravehicular activity, severely reducing the operation efficiency. To measure mechanical influence caused by spacesuit glove on muscle-tendon and joints, the present paper analyzes the movement anatomy and biomechanical characteristics of gripping, and then proposes a grip model. With phalangeal joint simplified as hinges, seven muscles as a finger grip energy unit, the Hill muscle model was used to compute the effects. We also used ANSYS in this study to establish a 3-D finite element model of an index finger which included both bones and muscles with glove, and then we verified the model. This model was applied to calculate the muscle stress in various situations of bare hands or hands wearing gloves in three different sizes. The results showed that in order to achieve normal grip strength with the influence caused by superfluous press, the finger's muscle stress should be increased to 5.4 times of that in normal situation, with most of the finger grip strength used to overcome the influence of superfluous pressure. When the gap between the finger surface and the glove is smaller, the mechanical influence which superfluous press made will decrease. The results would provide a theoretical basis for the design of the EVA Glove.

The effects of growth hormone treatment on bone mineral density and body composition in girls with turner syndrome.

PubMed

Ari, Mim; Bakalov, Vladimir K; Hill, Suvimol; Bondy, Carolyn A

2006-11-01

Many girls with Turner syndrome (TS) are treated with GH to increase adult height. In addition to promoting longitudinal bone growth, GH has effects on bone and body composition. The objective was to determine how GH treatment affects bone mineral density (BMD) and body composition in girls with TS. In a cross-sectional study, we compared measures of body composition and BMD by dual energy x-ray absorptiometry, and phalangeal cortical thickness by hand radiography in 28 girls with TS who had never received GH and 39 girls who were treated with GH for at least 1 yr. All girls were participants in a National Institutes of Health (NIH) Clinical Research Center (CRC) protocol between 2001 and 2006. The two groups were similar in age (12.3 yr, sd 2.9), bone age (11.5 yr, sd 2.6), and weight (42.8 kg, sd 16.6); but the GH-treated group was taller (134 vs. 137 cm, P = 0.001). The average duration of GH treatment was 4.2 (sd 3.2) yr (range 1-14 yr). After adjustment for size and bone age, there were no significant differences in BMD at L1-L4, 1/3 radius or cortical bone thickness measured at the second metacarpal. However, lean body mass percent was higher (P < 0.001), whereas body fat percent was lower (P < 0.001) in the GH-treated group. These effects were independent of estrogen exposure and were still apparent in girls that had finished GH treatment at least 1 yr previously. Although GH treatment has little effect on cortical or trabecular BMD in girls with TS, it is associated with increased lean body mass and reduced adiposity.

The structure of the cushions in the feet of African elephants (Loxodonta africana)

PubMed Central

Weissengruber, G E; Egger, G F; Hutchinson, J R; Groenewald, H B; Elsässer, L; Famini, D; Forstenpointner, G

2006-01-01

The uniquely designed limbs of the African elephant, Loxodonta africana, support the weight of the largest terrestrial animal. Besides other morphological peculiarities, the feet are equipped with large subcutaneous cushions which play an important role in distributing forces during weight bearing and in storing or absorbing mechanical forces. Although the cushions have been discussed in the literature and captive elephants, in particular, are frequently affected by foot disorders, precise morphological data are sparse. The cushions in the feet of African elephants were examined by means of standard anatomical and histological techniques, computed tomography (CT) and magnetic resonance imaging (MRI). In both the forelimb and the hindlimb a 6th ray, the prepollex or prehallux, is present. These cartilaginous rods support the metacarpal or metatarsal compartment of the cushions. None of the rays touches the ground directly. The cushions consist of sheets or strands of fibrous connective tissue forming larger metacarpal/metatarsal and digital compartments and smaller chambers which were filled with adipose tissue. The compartments are situated between tarsal, metatarsal, metacarpal bones, proximal phalanges or other structures of the locomotor apparatus covering the bones palmarly/plantarly and the thick sole skin. Within the cushions, collagen, reticulin and elastic fibres are found. In the main parts, vascular supply is good and numerous nerves course within the entire cushion. Vater–Pacinian corpuscles are embedded within the collagenous tissue of the cushions and within the dermis. Meissner corpuscles are found in the dermal papillae of the foot skin. The micromorphology of elephant feet cushions resembles that of digital cushions in cattle or of the foot pads in humans but not that of digital cushions in horses. Besides their important mechanical properties, foot cushions in elephants seem to be very sensitive structures. PMID:17118065

Using in situ hybridization and PFGE Southern hybridization to detect translocation breakpoints in a BOR/TRPS patient cell line

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gu, J.Z.; Sapru, M.; Smith, D.

Branchio-oto-renal syndrome (BOR) is an autosomal dominant disorder characterized by ear malformations, cervical fistulae, hearing loss and renal abnormalities. We have integrated the Genethon YAC contig maps with additional markers in the chromosome 8q region genetically linked by a unique patient cell line. This cell line is from a patient who has both the branchio-oto-renal syndrome and tricho-rhino-phalangeal syndrome (TRPS). High resolution cytogenetics demonstrated a direct insertion of materials from 8q13.3q21.13 to 8q24.11. TRPS has been previously linked to deletions involving 8q24.11-q24.13. The rearrangement in this patient suggests that TRPS results from loss of gene function due to insertion atmore » the 8q24.11 breakpoint and the possible location for the BOR gene is at either of the two breakpoints of 8q13.3 and 8q21.13. We have constructed cosmid contigs in 8q24.11. In situ hybridization with cosmids mapped to these locations as probes has helped to narrow down the breakpoints. Combinations of cosmids on either side or overlapping the 8q24.11 breakpoint show split signals on one chromosome 8q arm due to insertion of the materials from the proximal region. Cosmids mapped to the TRPS deletion region have been used to hybridize to pulsed field gel genomic blots of DNA from the patient cell line and detected rearranged genomic fragments. Both in situ hybridization and genomic PFGE Southern blot will be used to precisely locate the breakpoints.« less

Local morbidity from red-bellied black snake (Pseudechis porphyriacus, Elapidae) envenoming: Two cases and a brief review of management.

PubMed

Weinstein, Scott A; Mirtschin, Peter J; Tristram, Hamish; Lawton, Luke; White, Julian

2018-02-01

The red-bellied black snake (Pseudechis porphyriacus, Elapidae) is one of several species of venomous snakes most commonly implicated in human and domestic animal envenoming in Australia. Human systemic envenoming can present with myotoxicity that may include myoglobinuria; hemoglobinuria and intravascular hemolysis; thrombocytopenia, anticoagulant coagulopathy, and, rarely, mild cranial nerve palsies. Pseudechis porphyriacus envenoming can also feature significant local morbidity such as ecchymoses, bleeding, pain and necrosis. Some envenomed patients may develop progressive thickness necrosis independent of secondary infection, and occasionally require surgical debridement. Uncommonly, some digital envenoming may cause more severe deeper tissue pathology that justifies dermotomy and/or distal phalangeal amputation. Presented are two patients with significant local morbidity from P. porphyriacus envenoming. An 18-month old girl received a protracted envenoming on her right foot, while a 38-year old male professional zoologist was envenomed on the third digit of his right hand. Each patient experienced myotoxicity, one had anticoagulant coagulopathy, and both developed clinically significant local morbidity including persistent bleeding, ecchymoses, local necrosis and pain; each required extensive treatment and variably prolonged admission. Noted also were transiently elevated D-dimer with low-normal or normal fibrinogen levels. The progressive necrosis and subsequent chronic pathologic changes with ischemia of the latter patient's digit eventually required a dermotomy and amputation of the distal phalanx. The pediatric patient did not require extensive wound debridement, but experienced prolonged difficulty in ambulation because of slowly resolving wound discomfort. Factors that may contribute to the severity of local morbidity of P. porphyriacus envenoming are considered, and management of envenoming by this taxon is briefly reviewed. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Osteology of Icadyptes salasi, a giant penguin from the Eocene of Peru

PubMed Central

Ksepka, Daniel T; Clarke, Julia A; DeVries, Thomas J; Urbina, Mario

2008-01-01

We present the first detailed description of the giant Eocene penguin Icadyptes salasi. The species is characterized by a narrow skull with a hyper-elongate spear-like beak, a robust cervical column and a powerful flipper. The bony beak tip of Icadyptes is formed by fusion of several elements and is unique among penguins, differing markedly from previously described giant penguin beaks. Vascular canal patterning similar to that of boobies, frigatebirds and albatrosses suggests I. salasi may have had a thin, sheet-like rhamphotheca unlike the thick rugose rhamphotheca of modern penguins. Together, these features suggest a novel ecology for I. salasi, most likely involving the capture of larger prey items via spearing. As the first described giant penguin specimen to preserve a complete wing skeleton, the I. salasi holotype yields significant insight into the shape, proportions and orientation of the wing in giant penguins. In articulation, the forelimb of I. salasi is straighter, permitting less manus and antibrachium flexion, than previous depictions of giant penguin wings. Cross-sections of the humerus and ulna reveal a level of osteosclerosis equalling or surpassing that of extant penguins. Based on ontogenetic data from extant penguins and the morphology of the carpometacarpus of I. salasi, we infer the retention of a free alular phalanx in basal penguins. Previously, the status of this element in penguins was disputed. Differences in the proportions of the manual phalanges contribute to a more abruptly tapering wingtip in I. salasi compared with crown penguins. Fossils from Peru, including the I. salasi holotype specimen, document that penguins expanded to nearly the whole of their extant latitudinal range early in their evolutionary history and during one of the warmest intervals in the Cenozoic. PMID:18564073

[Melorheostosis associated with arteriovenous malformation of the ear].

PubMed

Ingen-Housz-Oro, S; Chigot, V; Hamel-Teillac, D; Brunelle, F; De Prost, Y

2001-09-01

Melorheostosis is a rare bone dystrophy that may be associated with various vascular malformations. We report a case of arteriovenous fistulae of the ear associated with melorheostosis limited to the same side of the body. A 13 year-old boy presented a congenital port-wine nevus of the right side of the head complicated by an arteriovenous fistulae and angiomatous nodules of the ear. He was treated by laser, surgery of the nodules, arterial embolisations and sclerotherapy. In 1999, he had a benign trauma of the right hand. The X-ray showed hyperostosis resembling wax flowing down a candle reaching the carpus and some of the metacarpals and the phalanges of the right hand, typical of melorheostosis. The complete radiographic check-up showed the same characteristic appearance on the right side of the skull and the long bones of the right upper limb. Except a deformation of the right fingers, there were no others symptoms. Melorheostosis is a rare, sporadic and benign bone dysplasia that may be localized to a single limb or disseminated. The diagnosis is usually made in late childhood. Pain, stiffness, deformation of a limb are the main clinical manifestations. The skin may be erythematous and sclerotic. The radiographic appearance is characteristic with hyperostosis on one side of the bone resembling wax flowing down a candle. A vascular abnormality is present in 17 p. 100 of cases (hemangiomas, aneurysms, renal artery stenosis.). In these cases, melorheostosis is usually limited to the same side of the vascular lesion. We report the first case of arteriovenous fistulae of the ear associated with melorheostosis, on the same side of the body. The physiopathology of melorheostosis is still unknown but the association with a homolateral vascular abnormality suggests a localized defect in embryogenesis of the vascular and skeletal systems.

Low second to fourth digit ratio in Dupuytren disease.

PubMed

Yokoi, Takuya; Uemura, Takuya; Kazuki, Kenichi; Onode, Ema; Shintani, Kosuke; Okada, Mitsuhiro; Nakamura, Hiroaki

2017-08-01

The ratio of the lengths of the second and fourth digits (2D:4D) has been described as reflecting endogenous prenatal androgen exposure. In general, 2D:4D is lower in men than in women and has potential as a biomarker or predictor for various diseases, athletic ability, and academic performance. Dupuytren disease has digital flexion contractures and is known to predominate in men, but the pathogenesis of the disease remains unclear. To clarify the relationships between Dupuytren disease and endogenous androgens, we performed a retrospective analysis of hand radiographs to investigate 2D:4D in Dupuytren disease. The study included male patients with Dupuytren disease (n = 22) and a control group (n = 18) of male patients with carpal tunnel syndrome. Only unaffected hands, without contractures or osteoarthritis, were evaluated for the purpose of radiographic assessment. The lengths of the phalanx and metacarpal bones in the second and fourth digits were measured by 2 independent observers who each performed 2 sets of measurements separated by a minimum 1-week interval. The 2D:4D was calculated separately for the phalanges and metacarpals, and a combined (phalanx + metacarpal) 2D:4D was also calculated. The reliability of the observer measurements was established using the intraclass correlation coefficient, and both the intra- and interobserver reliability showed excellent agreement. We found that compared with control group, the Dupuytren disease group had significantly lower phalanx and combined 2D:4D. These findings suggest that endogenous prenatal androgens could contribute to the development of Dupuytren disease, leading to its characteristic clinical presentation predominantly in men and affecting the ulnar rays.

A geometric analysis of hallux valgus: correlation with clinical assessment of severity

PubMed Central

Piqué-Vidal, Carlos; Vila, Joan

2009-01-01

Background Application of plane geometry to the study of bunion deformity may represent an interesting and novel approach in the research field of hallux valgus. For the purpose of contributing to development of a different perspective in the assessment of hallux valgus, this study was conducted with three objectives: a) to determine the position on the intersection point of the perpendicular bisectors of the longitudinal axes of the first metatarsal and proximal phalanx (IP), b) to correlate the location of this point with hallux valgus deformity according to angular measurements and according to visual assessment of the severity carried out by three independent observers, and c) to assess whether this IP correlated with the radius of the first metatarsophalangeal arc circumference. Methods Measurements evaluated were intermetatarsal angle (IMA), hallux valgus angle (HVA), and proximal phalangeal articular angle (PPAA). The Autocad® program computed the location of the IP inside or outside of the foot. Three independent observers rated the severity of hallux valgus in photographs using a 100-mm visual analogue scale (VAS). Results Measurements of all angles except PPAA showed significantly lower values when the IP was located out of the foot more distantly and vice versa, significantly higher values for severe deformities in which the IP was found inside the foot (p < 0.001). The IP correlated significantly with VAS scores and with the length of the radius of the circle that included the first metatarsophalangeal arc circumference (p < 0.001) Conclusion The IP is a useful indicator of hallux valgus deformity because correlated significantly with IMA and HVA measurements, VAS scores obtained by visual inspection of the degree of deformity, and location of the center of the first metatarsophalangeal arc circumference. PMID:19442286

[The reconstruction of the human body length from the wrist size].

PubMed

Grigor'eva, M A; Anushkina, E S

2015-01-01

The objective of the present study was to develop the regression models for the reconstruction of the human body length from the wrist size taking into consideration the availability of the results of the measurements of the palm fragments or the wrist undergoing muscular contracture. The study included 106 Caucasoid subjects (41 men and 65 women) at the age varying from 18 to 76 years. The following parameters were measured: body length, wrist length, the length of the fingers and phalanges on the back of the hand, palmar length and width, ulnar edge size of the palm. It was shown that the selected longitudinal dimensions of the palm and fingers can be used to estimate the body length as accurately as from the wrist length. The high prognostic value of ulnar edge size of the palm was documented which allows this characteristic to be used in the cases of partial palm destruction or in the wrist with pronounced flexion contracture of the fingers. The most exact equations are those derived from the combination of the results of the measurement of the fingers and the ulnar edge size of the palm. Less accurate equations are based on the palmar dimensions alone and on the total wrist size with the exception of the equation for the wrist length with regard to the subject's sex. The gender information needs to be taken into account if the wrist is preserved to the extent that only the length of the palm and of the IV and V fingers can be measured or if the wrist is sufficiently long and wide (short and wide) and the gender is supposed to be masculine. In contrast, this information should be disregarded if the wrist is long and narrow (short and narrow) and the gender is supposedly feminine.

Liver‐Directed Human Amniotic Epithelial Cell Transplantation Improves Systemic Disease Phenotype in Hurler Syndrome Mouse Model

PubMed Central

Rodriguez, Natalie S.; Yanuaria, Lisa; Parducho, Kevin Murphy R.; Garcia, Irving M.; Varghese, Bino A.; Grubbs, Brendan H.

2017-01-01

Abstract Mucopolysaccharidosis type 1 (MPS1) is an inherited lysosomal storage disorder caused by a deficiency in the glycosaminoglycan (GAG)‐degrading enzyme α‐l‐iduronidase (IDUA). In affected patients, the systemic accumulation of GAGs results in skeletal dysplasia, neurological degeneration, multiple organ dysfunction, and early death. Current therapies, including enzyme replacement and bone marrow transplant, improve life expectancy but the benefits to skeletal and neurological phenotypes are limited. In this study, we tested the therapeutic efficacy of liver‐directed transplantation of a placental stem cell, which possesses multilineage differentiation potential, low immunogenicity, and high lysosomal enzyme activity. Unfractionated human amniotic epithelial cells (hAECs) were transplanted directly into the liver of immunodeficient Idua knockout mouse neonates. The hAECs engraftment was immunohistochemically confirmed with anti‐human mitochondria staining. Enzyme activity assays indicated that hAECs transplantation restored IDUA function in the liver and significantly decreased urinary GAG excretion. Histochemical and micro‐computed tomography analyses revealed reduced GAG deposition in the phalanges joints and composition/morphology improvement of cranial and facial bones. Neurological assessment in the hAEC treated mice showed significant improvement of sensorimotor coordination in the hAEC treated mice compared to untreated mice. Results confirm that partial liver cell replacement with placental stem cells can provide long‐term (>20 weeks) and systemic restoration of enzyme function, and lead to significant phenotypic improvement in the MPS1 mouse model. This preclinical data indicate that liver‐directed placental stem cell transplantation may improve skeletal and neurological phenotypes of MPS1 patients. Stem Cells Translational Medicine 2017;6:1583–1594 PMID:28585336

Liver-Directed Human Amniotic Epithelial Cell Transplantation Improves Systemic Disease Phenotype in Hurler Syndrome Mouse Model.

PubMed

Rodriguez, Natalie S; Yanuaria, Lisa; Parducho, Kevin Murphy R; Garcia, Irving M; Varghese, Bino A; Grubbs, Brendan H; Miki, Toshio

2017-07-01

Mucopolysaccharidosis type 1 (MPS1) is an inherited lysosomal storage disorder caused by a deficiency in the glycosaminoglycan (GAG)-degrading enzyme α-l-iduronidase (IDUA). In affected patients, the systemic accumulation of GAGs results in skeletal dysplasia, neurological degeneration, multiple organ dysfunction, and early death. Current therapies, including enzyme replacement and bone marrow transplant, improve life expectancy but the benefits to skeletal and neurological phenotypes are limited. In this study, we tested the therapeutic efficacy of liver-directed transplantation of a placental stem cell, which possesses multilineage differentiation potential, low immunogenicity, and high lysosomal enzyme activity. Unfractionated human amniotic epithelial cells (hAECs) were transplanted directly into the liver of immunodeficient Idua knockout mouse neonates. The hAECs engraftment was immunohistochemically confirmed with anti-human mitochondria staining. Enzyme activity assays indicated that hAECs transplantation restored IDUA function in the liver and significantly decreased urinary GAG excretion. Histochemical and micro-computed tomography analyses revealed reduced GAG deposition in the phalanges joints and composition/morphology improvement of cranial and facial bones. Neurological assessment in the hAEC treated mice showed significant improvement of sensorimotor coordination in the hAEC treated mice compared to untreated mice. Results confirm that partial liver cell replacement with placental stem cells can provide long-term (>20 weeks) and systemic restoration of enzyme function, and lead to significant phenotypic improvement in the MPS1 mouse model. This preclinical data indicate that liver-directed placental stem cell transplantation may improve skeletal and neurological phenotypes of MPS1 patients. Stem Cells Translational Medicine 2017;6:1583-1594. © 2017 The Authors Stem Cells Translational Medicine published by Wiley Periodicals, Inc. on behalf of AlphaMed Press.

Gestational and Early Postnatal Exposure to an Environmentally Relevant Mixture of Brominated Flame Retardants: General Toxicity and Skeletal Variations.

PubMed

Tung, Emily W Y; Yan, Han; Lefèvre, Pavine L C; Berger, Robert G; Rawn, Dorothea F K; Gaertner, Dean W; Kawata, Alice; Rigden, Marc; Robaire, Bernard; Hales, Barbara F; Wade, Michael G

2016-06-01

Brominated flame retardants (BFRs) are stable environmental contaminants known to exert endocrine-disrupting effects. Developmental exposure to polybrominated diphenyl ethers (PBDEs) is correlated with impaired thyroid hormone signaling, as well as estrogenic and anti-androgenic effects. As previous studies have focused on a single congener or technical mixture, the purpose of the current study was to examine the effects of gestational and early postnatal exposure to an environmentally relevant mixture of BFRs designed to reflect house dust levels of PBDEs and hexabromocyclododecane on postnatal developmental outcomes. Pregnant Sprague-Dawley rats were exposed to the PBDE mixture from preconception to weaning (PND 21) through the diet containing 0, 0.75, 250, and 750 mg mixture/kg diet. BFR exposure induced transient reductions in body weight at PND 35 in male and from PND 30-45 in female offspring (250 and 750 mg/kg). Liver weights (PND 21) and xenobiotic metabolizing enzyme activities (PND 21 and 46) were increased in both male and female offspring exposed to 250 and 750 mg/kg diets. Furthermore, serum T4 levels were reduced at PND 21 in both,male and female offspring (250 and 750 mg/kg). At PND 21, Serum alkaline phosphatase (ALP) was decreased in males exposed to 750 mg/kg dietat, and females exposed to 250 and 750 mg/kg diets. At PND 46 ALP was significantly elevated in males (250 and 750 mg/kg). Variations in the cervical vertebrae and phalanges were observed in pups at PND 4 (250 and 750 mg/kg). Therefore, BFR exposure during gestation through to weaning alters developmental programming in the offspring. The persistence of BFRs in the environment remains a cause for concern with regards to developmental toxicity. © 2016 Wiley Periodicals, Inc.

Exposure to an environmentally relevant mixture of brominated flame retardants affects fetal development in Sprague-Dawley rats.

PubMed

Berger, Robert G; Lefèvre, Pavine L C; Ernest, Sheila R; Wade, Michael G; Ma, Yi-Qian; Rawn, Dorothea F K; Gaertner, Dean W; Robaire, Bernard; Hales, Barbara F

2014-06-05

Brominated flame retardants are incorporated into a wide variety of consumer products and are known to enter into the surrounding environment, leading to human exposure. There is accumulating evidence that these compounds have adverse effects on reproduction and development in humans and animal models. Animal studies have generally characterized the outcome of exposure to a single technical mixture or congener. Here, we determined the impact of exposure of rats prior to mating and during gestation to a mixture representative of congener levels found in North American household dust. Adult female Sprague-Dawley rats were fed a diet containing 0, 0.75, 250 or 750mg/kg of a mixture of flame retardants (polybrominated diphenyl ethers, hexabromocyclododecane) from two weeks prior to mating to gestation day 20. This formulation delivered nominal doses of 0, 0.06, 20 and 60mg/kg body weight/day. The lowest dose approximates high human exposures based on house dust levels and the dust ingestion rates of toddlers. Litter size and resorption sites were counted and fetal development evaluated. No effects on maternal health, litter size, fetal viability, weights, crown rump lengths or sex ratios were detected. The proportion of litters with fetuses with anomalies of the digits (soft tissue syndactyly or malposition of the distal phalanges) was increased significantly in the low (0.06mg/kg/day) dose group. Skeletal analysis revealed a decreased ossification of the sixth sternebra at all exposure levels. Thus, exposure to an environmentally relevant mixture of brominated flame retardants results in developmental abnormalities in the absence of apparent maternal toxicity. The relevance of these findings for predicting human risk is yet to be determined. Copyright © 2014. Published by Elsevier Ireland Ltd.

Prospective evaluation of risk of vertebral fractures using quantitative ultrasound measurements and bone mineral density in a population-based sample of postmenopausal women: results of the Basel Osteoporosis Study.

PubMed

Hollaender, R; Hartl, F; Krieg, M-A; Tyndall, A; Geuckel, C; Buitrago-Tellez, C; Manghani, M; Kraenzlin, M; Theiler, R; Hans, D

2009-03-01

Prospective studies have shown that quantitative ultrasound (QUS) techniques predict the risk of fracture of the proximal femur with similar standardised risk ratios to dual-energy x-ray absorptiometry (DXA). Few studies have investigated these devices for the prediction of vertebral fractures. The Basel Osteoporosis Study (BOS) is a population-based prospective study to assess the performance of QUS devices and DXA in predicting incident vertebral fractures. 432 women aged 60-80 years were followed-up for 3 years. Incident vertebral fractures were assessed radiologically. Bone measurements using DXA (spine and hip) and QUS measurements (calcaneus and proximal phalanges) were performed. Measurements were assessed for their value in predicting incident vertebral fractures using logistic regression. QUS measurements at the calcaneus and DXA measurements discriminated between women with and without incident vertebral fracture, (20% height reduction). The relative risks (RRs) for vertebral fracture, adjusted for age, were 2.3 for the Stiffness Index (SI) and 2.8 for the Quantitative Ultrasound Index (QUI) at the calcaneus and 2.0 for bone mineral density at the lumbar spine. The predictive value (AUC (95% CI)) of QUS measurements at the calcaneus remained highly significant (0.70 for SI, 0.72 for the QUI, and 0.67 for DXA at the lumbar spine) even after adjustment for other confounding variables. QUS of the calcaneus and bone mineral density measurements were shown to be significant predictors of incident vertebral fracture. The RRs for QUS measurements at the calcaneus are of similar magnitude as for DXA measurements.

[Hand injuries from combat sports].

PubMed

Hanna, W A; Laier, P

2015-06-01

Each year 3.1% of German adults suffer from accidents related to sports and 75% of the injured athletes are male between 20 and 29 years old. The upper limbs are affected in more than 20% of cases and one third of these injuries involve the hands and fingers. More than half a million athletes are organized in combat sport associations in Germany with an increasing trend. Combat sports are commonly said to have a high risk of injuries to the hand. The aim of this study was to test this hypothesis as well as to describe typical hand injuries associated with combat sports. A systematic review of literature (up to January 2015) in PubMed/Medline and The Cochrane Library as well as a secondary search in the reference lists were carried out. Conclusive comparative studies on the incidence and severity of hand injuries directly related to combat sports action could not be found in the currently available literature. The overall risk of suffering from a sports injury seems to be relatively low in combat sports compared to other sports. Boxing, however, seems to be the most dangerous sport for injuries to the upper extremities and especially the hand. The injury pattern after punching (emergency patients and professional boxers) shows that more than half of these fractures affect the 5th metacarpal and 25% of these are the classical boxer's fracture. This differs significantly from the fracture distribution generally associated with sports, where fractures of the phalanges are the most common. Two rare conditions that may occur as a result of repeated punching are referred to as carpal bossing and boxer's knuckle and excellent results are described for both injury forms after surgical therapy.

Population demography of an endangered lizard, the Blue Mountains Water Skink

PubMed Central

2013-01-01

Background Information on the age structure within populations of an endangered species can facilitate effective management. The Blue Mountains Water Skink (Eulamprus leuraensis) is a viviparous scincid lizard that is restricted to < 40 isolated montane swamps in south-eastern Australia. We used skeletochronology of phalanges (corroborated by mark-recapture data) to estimate ages of 222 individuals from 13 populations. Results These lizards grow rapidly, from neonatal size (30 mm snout-vent length) to adult size (about 70 mm SVL) within two to three years. Fecundity is low (mean 2.9 offspring per litter) and is affected by maternal body length and age. Offspring quality may decline with maternal age, based upon captive-born neonates (older females gave birth to slower offspring). In contrast to its broadly sympatric (and abundant) congener E. tympanum, E. leuraensis is short-lived (maximum 6 years, vs 15 years for E. tympanum). Litter size and offspring size are similar in the two species, but female E. leuraensis reproduce annually whereas many E. tympanum produce litters biennially. Thus, a low survival rate (rather than delayed maturation or low annual fecundity) is the key reason why E. leuraensis is endangered. Our 13 populations exhibited similar growth rates and population age structures despite substantial variation in elevation, geographic location and swamp size. However, larger populations (based on a genetic estimate of effective population size) contained older lizards, and thus a wider variance in ages. Conclusion Our study suggests that low adult survival rates, as well as specialisation on a rare and fragmented habitat type (montane swamps) contribute to the endangered status of the Blue Mountains Water Skink. PMID:23402634

The often overlooked digital tuft: clues to diagnosis and pathophysiology of neuropathic disease and spondyloarthropathy

PubMed Central

Rothschild, B; Behnam, S

2005-01-01

Objective: To assess diagnostic implications of abnormalities of the pedal digital tufts and to identify features to facilitate distinguishing of spondyloarthropathy and leprosy. Background: Better criteria for distinguishing between these disorders are necessary if their character, natural history, and evolution are to be understood. Methods: Pedal x rays of 91 consecutive patients with diabetes, 21 alcoholic patients, 100 with spondyloarthropathy, 8 with scleroderma, and 137 with leprosy, and 188 defleshed skeletons of individuals with alcoholism, syphilis, cerebrovascular disease, and paraplegia from the Terry and Hamman-Todd collections were examined for evidence of osseous and articular pathologies. Digital tuft abnormalities were divided into irregularity, divot, flattening, resorption, whittling, and fragmentation. Results: Tuft divots were more common in alcoholics than in diabetic, and were more common in both than in the other groups studied. Tuft flattening was limited to alcoholic and neurosyphilis groups. Tuft whittling was especially prominent among individuals with spondyloarthropathy, contrasted with leprosy and diabetes. Aligned fractures were more common in diabetics than individuals with leprosy. Misaligned fractures were limited to individuals with leprosy and neurosyphilis. Leprosy and spondyloarthropathy were complicated by phalangeal and metatarsal whittling more commonly than other diseases studied. Background pedal abnormalities, derived from individuals with cardiovascular syphilis, cerebrovascular accidents, and paraplegia, was limited to abnormal divots only. Conclusions: Pedal digital tufts undergo a variety of pathological alterations useful in the recognition of disorders traditionally considered neuropathic in aetiology and in distinguishing differential considerations. Tuft flattening appears specific for alcoholism and neurosyphilis, and misaligned fractures seem specific for neurosyphilis and leprosy, providing differential assistance related to spondyloarthropathy. Conversely, periosteal reaction distinguishes spondyloarthropathy from leprosy. PMID:15647437

Entheseal involvement in asymptomatic human immunodeficiency virus infected patients: preliminary results of a clinical and ultrasonographic study.

PubMed

Ciancio, Giovanni; Sighinolfi, Laura; Furini, Federica; Segala, Daniela; Farina, Ilaria; Galuppi, Elisa; De Stefani, Elena; Simone, Loredana; Boccia, Sergio; Grilli, Anastasio; Pazzi, Paolo; Libanore, Marco; Contini, Carlo; Govoni, Marcello

2018-05-24

As a strong association between human immunodeficiency virus (HIV) infection and spondyloarthritis (SpA) has been hypothesised, our main objective was to explore by power Doppler ultrasonography (PDUS) the presence of subclinical enthesitis in asymptomatic HIV patients. The presence of subclinical synovitis was also evaluated. Consecutive asymptomatic HIV patients were studied and compared with asymptomatic HCV patients and healthy controls (HC). All subjects underwent a clinical and PDUS bilateral examination of the following entheses and joints: epicondyle, quadriceps, patellar, Achilles and plantar fascia; wrists, II and III metacarpo-phalangeal, knee and ankle. Twenty-nine HIV, 32 HCV and 25 HC were recruited; 1.032 entheses and 860 joints were examined. Clinical diagnosis of enthesitis was made in 10.3% HIV patients, 6.2% HCV patients (p=0.66) and none HC (p=0.24). PDUS enthesitis was found in 72.4% HIV, 28.1% HCV (p=0.0008) and 12% HC (p<0.0001). Clinical diagnosis of synovitis was made in 3.4% HIV patients, 9.3% HCV patients (p=0.61) and none HC (p=1). PDUS abnormalities were documented in 24.1% HIV patients, 71.8% HCV patients (p=0.0003) and none HC (p=0.0001). In detecting enthesitis and synovitis, PDUS was more sensitive than clinical examination both in HIV and HCV patients. Our preliminary study shows the high frequency of PDUS enthesitis in asymptomatic HIV patients, which highlights the close link between HIV and SpA. Further studies are desirable on a larger number of HIV patients to confirm these results. PDUS proved to be more sensitive than clinical examination in detecting subclinical involvement of entheses and joints.

Split-Hand/Split-Foot Malformation Is Caused by Mutations in the p63 Gene on 3q27

PubMed Central

Ianakiev, Peter; Kilpatrick, Michael W.; Toudjarska, Iva; Basel, Donald; Beighton, Peter; Tsipouras, Petros

2000-01-01

Split-hand/split-foot malformation (SHFM), a limb malformation involving the central rays of the autopod and presenting with syndactyly, median clefts of the hands and feet, and aplasia and/or hypoplasia of the phalanges, metacarpals, and metatarsals, is phenotypically analogous to the naturally occurring murine Dactylaplasia mutant (Dac). Results of recent studies have shown that, in heterozygous Dac embryos, the central segment of the apical ectodermal ridge (AER) degenerates, leaving the anterior and posterior segments intact; this finding suggests that localized failure of ridge maintenance activity is the fundamental developmental defect in Dac and, by inference, in SHFM. Results of gene-targeting studies have demonstrated that p63, a homologue of the cell-cycle regulator TP53, plays a critically important role in regulation of the formation and differentiation of the AER. Two missense mutations, 724A→G, which predicts amino acid substitution K194E, and 982T→C, which predicts amino acid substitution R280C, were identified in exons 5 and 7, respectively, of the p63 gene in two families with SHFM. Two additional mutations (279R→H and 304R→Q) were identified in families with EEC (ectrodactyly, ectodermal dysplasia, and facial cleft) syndrome. All four mutations are found in exons that fall within the DNA-binding domain of p63. The two amino acids mutated in the families with SHFM appear to be primarily involved in maintenance of the overall structure of the domain, in contrast to the p63 mutations responsible for EEC syndrome, which reside in amino acid residues that directly interact with the DNA. PMID:10839977

Structural scene analysis and content-based image retrieval applied to bone age assessment

NASA Astrophysics Data System (ADS)

Fischer, Benedikt; Brosig, André; Deserno, Thomas M.; Ott, Bastian; Günther, Rolf W.

2009-02-01

Radiological bone age assessment is based on global or local image regions of interest (ROI), such as epiphyseal regions or the area of carpal bones. Usually, these regions are compared to a standardized reference and a score determining the skeletal maturity is calculated. For computer-assisted diagnosis, automatic ROI extraction is done so far by heuristic approaches. In this work, we apply a high-level approach of scene analysis for knowledge-based ROI segmentation. Based on a set of 100 reference images from the IRMA database, a so called structural prototype (SP) is trained. In this graph-based structure, the 14 phalanges and 5 metacarpal bones are represented by nodes, with associated location, shape, as well as texture parameters modeled by Gaussians. Accordingly, the Gaussians describing the relative positions, relative orientation, and other relative parameters between two nodes are associated to the edges. Thereafter, segmentation of a hand radiograph is done in several steps: (i) a multi-scale region merging scheme is applied to extract visually prominent regions; (ii) a graph/sub-graph matching to the SP robustly identifies a subset of the 19 bones; (iii) the SP is registered to the current image for complete scene-reconstruction (iv) the epiphyseal regions are extracted from the reconstructed scene. The evaluation is based on 137 images of Caucasian males from the USC hand atlas. Overall, an error rate of 32% is achieved, for the 6 middle distal and medial/distal epiphyses, 23% of all extractions need adjustments. On average 9.58 of the 14 epiphyseal regions were extracted successfully per image. This is promising for further use in content-based image retrieval (CBIR) and CBIR-based automatic bone age assessment.

Conditional inactivation of Has2 reveals a crucial role for hyaluronan in skeletal growth, patterning, chondrocyte maturation and joint formation in the developing limb

PubMed Central

Matsumoto, Kazu; Li, Yingcui; Jakuba, Caroline; Sugiyama, Yoshinori; Sayo, Tetsuya; Okuno, Misako; Dealy, Caroline N.; Toole, Bryan P.; Takeda, Junji; Yamaguchi, Yu; Kosher, Robert A.

2009-01-01

Summary The glycosaminoglycan hyaluronan (HA) is a structural component of extracellular matrices and also interacts with cell surface receptors to directly influence cell behavior. To explore functions of HA in limb skeletal development, we conditionally inactivated the gene for HA synthase 2, Has2, in limb bud mesoderm using mice that harbor a floxed allele of Has2 and mice carrying a limb mesoderm-specific Prx1-Cre transgene. The skeletal elements of Has2-deficient limbs are severely shortened, indicating that HA is essential for normal longitudinal growth of all limb skeletal elements. Proximal phalanges are duplicated in Has2 mutant limbs indicating an involvement of HA in patterning specific portions of the digits. The growth plates of Has2-deficient skeletal elements are severely abnormal and disorganized, with a decrease in the deposition of aggrecan in the matrix and a disruption in normal columnar cellular relationships. Furthermore, there is a striking reduction in the number of hypertrophic chondrocytes and in the expression domains of markers of hypertrophic differentiation in the mutant growth plates, indicating that HA is necessary for the normal progression of chondrocyte maturation. In addition, secondary ossification centers do not form in the central regions of Has2 mutant growth plates owing to a failure of hypertrophic differentiation. In addition to skeletal defects, the formation of synovial joint cavities is defective in Has2-deficient limbs. Taken together, our results demonstrate that HA has a crucial role in skeletal growth, patterning, chondrocyte maturation and synovial joint formation in the developing limb. PMID:19633173

Angular stable lateral plating is a valid alternative to conventional plate fixation in the proximal phalanx. A biomechanical study.

PubMed

Shanmugam, R; Ernst, M; Stoffel, K; Fischer, M F; Wahl, D; Richards, R G; Gueorguiev, B

2015-06-01

Dorsal plating is commonly used in proximal phalanx fractures but it bears the risk of interfering with the extensor apparatus. In this study, dorsal and lateral plating fixation methods are compared to assess biomechanical differences using conventional 1.5mm non-locking plates and novel 1.3mm lateral locking plates. Twenty-four fresh frozen human cadaveric proximal phalanges were equally divided into four groups. An osteotomy was set at the proximal metaphyseal-diaphyseal junction and fixed with either dorsal (group A) or lateral (group B) plating using a 1.5mm non-locking plate, or lateral plating with a novel 1.3mm locking plate with bicortical (group C) or unicortical (group D) screws. The specimens were loaded in axial, dorsovolar and mediolateral direction to assess fixation stiffness followed by a cyclic destructive test in dorsovolar loading direction. Axial stiffness was highest in group D (mean 321.02, SEM 21.47N/mm) with a significant difference between groups D and B (P=0.033). Locking plates (groups C and D) were stiffer than non-locking plates under mediolateral loading (P=0.007), no significant differences were noted under dorsovolar loading. Furthermore, no significant differences were observed under cyclic loading to failure between any of the study groups. No considerable biomechanical advantage of using a conventional 1.5mm dorsal non-locking plate was identified over the novel 1.3mm lateral locking plate in the treatment of proximal phalanx fractures. Since the novel low-profile plate is less disruptive to the extensor mechanism, it should be considered as a valid alternative. Copyright © 2015 Elsevier Ltd. All rights reserved.

The physiological role of CTGF/CCN2 in zebrafish notochond development and biological analysis of the proximal promoter region.

PubMed

Chiou, Ming-Jyun; Chao, Tsung-Tai; Wu, Jen-Leih; Kuo, Ching-Ming; Chen, Jyh-Yih

2006-10-20

During mouse embryogenesis, CTGF/CCN2 is expressed in zones containing hypertrophic chondroctyes and calcifying cartilage such as long bones, ribs, vertebral column, and phalanges. But in fish, its expression is yet unclear. Development of the vertebrae is morphologically similar among vertebrates, indicating that the underlying mechanism regulating the process is highly conserved during evolution. Analysis of 3.2kb of the CTGF/CCN2 proximal promoter sequence revealed a consensus TATAA box, putative AP1, Brn-2, CdxA, C/EBP alpha, C/EBP beta, C-Ets-, delta E, HFH-2, and HSF2 binding sites. Transient expression experiments with a 5'-deletion revealed at least 4 regulatory regions in the zebrafish CTGF/CCN2 gene, 2 with a stimulatory effect on transcription and 2 with an apparent inhibitory effect after IGF-I treatment in the ZFL cell line. To study the promoter-specific expression, we constructed a series of CTGF/CCN2 (3.0-, 2.5-, 2.0-, 1.5-, 1.0-, and 0.4-kb) promoter-driven green fluorescent protein (GFP) fragments encoding the GFP cDNA transgene which was microinjected into zebrafish embryos. Morphological studies of transgenic zebrafish indicated that the CTGF/CCN2 promoter-driven GFP transcripts appeared in the notochord. Targeted knockdown of the CTGF/CCN2 gene by two antisense morpholino oligonucleotides resulted in disruptions to notochord development. From a comparative point of view, this study of the CTGF/CCN2 gene in zebrafish may correlate well with those previously published on the mouse. These molecular results suggest that CTGF/CCN2 plays an important role in notochord development and is required for general embryonic development.

Developmental toxicity evaluation of Bendectin in CD rats.

PubMed

Tyl, R W; Price, C J; Marr, M C; Kimmel, C A

1988-06-01

Bendectin, composed of doxylamine succinate and pyridoxine HCl (1:1), is an antinauseant previously prescribed for nausea and vomiting during pregnancy. The present study examined the maternal and developmental effects of Bendectin (0, 200, 500, or 800 mg/kg/day, po) administered to timed-pregnant CD rats (36-41/group) during organogenesis (gestational days [gd] 6-15). At death (gd 20), all live fetuses were examined for external, visceral, and skeletal abnormalities. At 500 and 800 mg/kg/day, maternal toxicity included reduced food consumption during treatment and for the gestation period, increased water consumption in the posttreatment period, reduced weight gain during treatment, and sedation; water consumption was reduced during treatment and for the gestation period, and maternal mortality (17.1%) was observed only at the high dose. Developmental toxicity included reduced prenatal viability (800 mg/kg/day) and reduced fetal body weight/litter (500 and 800 mg/kg/day). In addition, reduced ossification of metacarpals (800 mg/kg/day), phalanges of the forelimbs (500 and 800 mg/kg/day), and of caudal vertebral centra (all doses) was observed. No increase in percent malformed live fetuses/litter was observed. The proportion of litters with one or more malformed fetuses was higher than vehicle controls only at 800 mg/kg/day, with short 13th rib (to which the test species is predisposed) as the predominant observation. By contrast, a positive control agent (nitrofen, 50 mg/kg/day, po, 14 dams) produced 85% malformed fetuses/litter with the predominant malformation being diaphragmatic hernia. In conclusion, the incidence of litters with one or more malformed fetuses was increased only at a dose of Bendectin which produced maternal mortality (17.1%) and other indices of maternal and developmental toxicity (see Discussion).

Tissue engineering a human phalanx.

PubMed

Landis, W J; Chubinskaya, S; Tokui, T; Wada, Y; Isogai, N; Jacquet, R

2017-08-01

A principal purpose of tissue engineering is the augmentation, repair or replacement of diseased or injured human tissue. This study was undertaken to determine whether human biopsies as a cell source could be utilized for successful engineering of human phalanges consisting of both bone and cartilage. This paper reports the use of cadaveric human chondrocytes and periosteum as a model for the development of phalanx constructs. Two factors, osteogenic protein-1 [OP-1/bone morphogenetic protein-7 (BMP7)], alone or combined with insulin-like growth factor (IGF-1), were examined for their potential enhancement of chondrocytes and their secreted extracellular matrices. Design of the study included culture of chondrocytes and periosteum on biodegradable polyglycolic acid (PGA) and poly-l-lactic acid (PLLA)-poly-ε-caprolactone (PCL) scaffolds and subsequent implantation in athymic nu/nu (nude) mice for 5, 20, 40 and 60 weeks. Engineered constructs retrieved from mice were characterized with regard to genotype and phenotype as a function of developmental (implantation) time. Assessments included gross observation, X-ray radiography or microcomputed tomography, histology and gene expression. The resulting data showed that human cell-scaffold constructs could be successfully developed over 60 weeks, despite variability in donor age. Cartilage formation of the distal phalanx models enhanced with both OP-1 and IGF-1 yielded more cells and extracellular matrix (collagen and proteoglycans) than control chondrocytes without added factors. Summary data demonstrated that human distal phalanx models utilizing cadaveric chondrocytes and periosteum were successfully fabricated and OP-1 and OP-1/IGF-1 accelerated construct development and mineralization. The results suggest that similar engineering and transplantation of human autologous tissues in patients are clinically feasible. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Kinematic performance of a six degree-of-freedom hand model (6DHand) for use in occupational biomechanics.

PubMed

Buczek, Frank L; Sinsel, Erik W; Gloekler, Daniel S; Wimer, Bryan M; Warren, Christopher M; Wu, John Z

2011-06-03

Upper extremity musculoskeletal disorders represent an important health issue across all industry sectors; as such, the need exists to develop models of the hand that provide comprehensive biomechanics during occupational tasks. Previous optical motion capture studies used a single marker on the dorsal aspect of finger joints, allowing calculation of one and two degree-of-freedom (DOF) joint angles; additional algorithms were needed to define joint centers and the palmar surface of fingers. We developed a 6DOF model (6DHand) to obtain unconstrained kinematics of finger segments, modeled as frusta of right circular cones that approximate the palmar surface. To evaluate kinematic performance, twenty subjects gripped a cylindrical handle as a surrogate for a powered hand tool. We hypothesized that accessory motions (metacarpophalangeal pronation/supination; proximal and distal interphalangeal radial/ulnar deviation and pronation/supination; all joint translations) would be small (less than 5° rotations, less than 2mm translations) if segment anatomical reference frames were aligned correctly, and skin movement artifacts were negligible. For the gripping task, 93 of 112 accessory motions were small by our definition, suggesting this 6DOF approach appropriately models joints of the fingers. Metacarpophalangeal supination was larger than expected (approximately 10°), and may be adjusted through local reference frame optimization procedures previously developed for knee kinematics in gait analysis. Proximal translations at the metacarpophalangeal joints (approximately 10mm) were explained by skin movement across the metacarpals, but would not corrupt inverse dynamics calculated for the phalanges. We assessed performance in this study; a more rigorous validation would likely require medical imaging. Published by Elsevier Ltd.

Developmental outcome of levetiracetam, its major metabolite in humans, 2-pyrrolidinone N-butyric acid, and its enantiomer (R)-alpha-ethyl-oxo-pyrrolidine acetamide in a mouse model of teratogenicity.

PubMed

Isoherranen, Nina; Spiegelstein, Ofer; Bialer, Meir; Zhang, Jing; Merriweather, Michelle; Yagen, Boris; Roeder, Michael; Triplett, Aleata A; Schurig, Volker; Finnell, Richard H

2003-10-01

The purpose of this study was to test the teratogenic potential of the antiepileptic drug (AED) levetiracetam (LEV), its major metabolite in humans, 2-pyrrolidone-N-butyric acid (PBA), and enantiomer, (R)-alpha-ethyl-oxo-pyrrolidine acetamide (REV), in a well-established mouse model. All compounds were administered by intraperitoneal injections once daily to SWV/Fnn mice on gestational days 8-1/2 to 12-1/2. LEV was administered at doses of 600, 1,200, and 2,000 mg/kg/day, piracetam (PIR) and PBA, at 600 and 1,200 mg/kg/day, and REV, at 600 mg/kg/day. On gestational day 18(1/2), fetuses were examined for gross external malformations and prepared for skeletal analysis by using Alizarin Red S staining. No significant gross external malformations were observed in any of the study groups. Fetal weights were significantly reduced in most study groups. Resorption rates were significantly increased only in the 2,000-mg/kg/day LEV group. The overall incidence of skeletal abnormalities and specifically of hypoplastic phalanges was significantly increased in both PBA treatments and in the intermediate 1,200-mg/kg/day LEV group. In contrast to that in humans, 24-h urinary excretion analysis in mice showed that 65-100% of the LEV doses were excreted unchanged, whereas only 4% was excreted as the metabolite PBA. Results of this study demonstrate that both LEV and its major metabolite in humans, PBA, do not induce major structural malformations in developing SWV/Fnn embryos and suggest that they provide a margin of reproductive safety for the pregnant epileptic population when compared with other AEDs tested in this mouse model.

Attenuation of bone morphogenetic protein signaling during amphibian limb development results in the generation of stage-specific defects.

PubMed

Jones, Tamsin E M; Day, Robert C; Beck, Caroline W

2013-11-01

The vertebrate limb is one of the most intensively studied organs in the field of developmental biology. Limb development in tetrapod vertebrates is highly conserved and dependent on the interaction of several important molecular pathways. The bone morphogenetic protein (BMP) signaling cascade is one of these pathways and has been shown to be crucial for several aspects of limb development. Here, we have used a Xenopus laevis transgenic line, in which expression of the inhibitor Noggin is under the control of the heat-shock promoter hsp70 to examine the effects of attenuation of BMP signaling at different stages of limb development. Remarkably different phenotypes were produced at different stages, illustrating the varied roles of BMP in development of the limb. Very early limb buds appeared to be refractory to the effects of BMP attenuation, developing normally in most cases. Ectopic limbs were produced by overexpression of Noggin corresponding to a brief window of limb development at about stage 49/50, as recently described by Christen et al. (2012). Attenuation of BMP signaling in stage 51 or 52 tadpoles lead to a reduction in the number of digits formed, resulting in hypodactyly or ectrodactyly, as well as occasional defects in the more proximal tibia-fibula. Finally, inhibition at stage 54 (paddle stage) led to the formation of dramatically shortened digits resulting from loss of distal phalanges. Transcriptome analysis has revealed the possibility that more Noggin-sensitive members of the BMP family could be involved in limb development than previously suspected. Our analysis demonstrates the usefulness of heat-shock-driven gene expression as an effective method for inhibiting a developmental pathway at different times during limb development. © 2013 Anatomical Society.

Simplified radius, ulna, and short bone-age assessment procedure using grouped-Tanner-Whitehouse method.

PubMed

Hsieh, Chi-Wen; Liu, Tzu-Chiang; Wang, Jui-Kai; Jong, Tai-Lang; Tiu, Chui-Mei

2011-08-01

The Tanner-Whitehouse III (TW3) method is popular for assessing children's bone age, but it is time-consuming in clinical settings; to simplify this, a grouped-TW algorithm (GTA) was developed. A total of 534 left-hand roentgenograms of subjects aged 2-15 years, including 270 training and 264 testing datasets, were evaluated by a senior pediatrician. Next, GTA was used to choose the appropriate candidate of radius, ulna, and short bones and to classify the bones into three groups by data mining. Group 1 was composed of the maturity pattern of the radius and the middle phalange of the third and fifth digits and three weights were obtained by data mining, yielding a result similar to that of TW3. Subsequently, new bone-age assessment tables were constructed for boys and girls by linear regression and fuzzy logic. In addition, the Bland-Altman plot was utilized to compare accuracy between the GTA, the Greulich-Pyle (GP), and the TW3 method. The relative accuracy between the GTA and the TW3 was 96.2% in boys and 95% in girls, with an error of 1 year, while that between the assessment results of the GP and TW3 was about 87%, with an error of 1 year. However, even if the three weights were not optimally processed, GTA yielded a marginal result with an accuracy of 78.2% in boys and 79.6% in girls. GTA can efficiently simplify the complexity of the TW3 method, while maintaining almost the same accuracy. The relative accuracy between the assessment results of GTA and GP can also be marginal. © 2011 The Authors. Pediatrics International © 2011 Japan Pediatric Society.

The manual pressures of stone tool behaviors and their implications for the evolution of the human hand.

PubMed

Williams-Hatala, Erin Marie; Hatala, Kevin G; Gordon, McKenzie; Key, Alastair; Kasper, Margaret; Kivell, Tracy L

2018-06-01

It is widely agreed that biomechanical stresses imposed by stone tool behaviors influenced the evolution of the human hand. Though archaeological evidence suggests that early hominins participated in a variety of tool behaviors, it is unlikely that all behaviors equally influenced modern human hand anatomy. It is more probable that a behavior's likelihood of exerting a selective pressure was a weighted function of the magnitude of stresses associated with that behavior, the benefits received from it, and the amount of time spent performing it. Based on this premise, we focused on the first part of that equation and evaluated magnitudes of stresses associated with stone tool behaviors thought to have been commonly practiced by early hominins, to determine which placed the greatest loads on the digits. Manual pressure data were gathered from 39 human subjects using a Novel Pliance ® manual pressure system while they participated in multiple Plio-Pleistocene tool behaviors: nut-cracking, marrow acquisition with a hammerstone, flake production with a hammerstone, and handaxe and flake use. Manual pressure distributions varied significantly according to behavior, though there was a tendency for regions of the hand subject to the lowest pressures (e.g., proximal phalanges) to be affected less by behavior type. Hammerstone use during marrow acquisition and flake production consistently placed the greatest loads on the digits collectively, on each digit and on each phalanx. Our results suggest that, based solely on the magnitudes of stresses, hammerstone use during marrow acquisition and flake production are the most likely of the assessed behaviors to have influenced the anatomical and functional evolution of the human hand. Copyright © 2018 Elsevier Ltd. All rights reserved.

An in vitro biomechanical comparison of two fixation methods for transverse osteotomies of the medial proximal forelimb sesamoid bones in horses.

PubMed

Wilson, D A; Keegan, K G; Carson, W L

1999-01-01

This study compared the mechanical properties of the normal intact suspensory apparatus and two methods of fixation for repair of transverse, midbody fractures of the proximal sesamoid bones of adult horses: transfixation wiring (TW) and screws placed in lag fashion (LS). An in vitro, paired study using equine cadaver limbs mounted in a loading apparatus was used to test the mechanical properties of TW and LS. Seventeen paired (13 repaired, 4 normal) equine cadaver limbs consisting of the suspensory apparatus third metacarpal bone, and first and second phalanges. The two methods of repair and normal intact specimens were evaluated in single cycle-to-failure loading. Yield failure was defined to occur at the first notable discontinuity (>50 N) in the load-displacement curve, the first visible failure as evident on the videotape, or a change in the slope of the moment-fetlock angle curve. Ultimate failure was defined to occur at the highest load resisted by the specimen. Corresponding resultant force and force per kg of body weight on the suspensory apparatus, fetlock joint moment, and angle of fetlock dorsiflexion were calculated by use of specimen dimensions and applied load. These were compared along with specimen stiffness, and ram displacement. Load on the suspensory apparatus, load on the suspensory apparatus per kg of body weight, moment, applied load, and angle of fetlock dorsiflexion at yield failure were significantly greater for the TW-repaired than for the LS-repaired specimens. A 3 to 5 mm gap was observed before yield failure in most TW-repaired osteotomies. Transfixation wiring provided greater strength to yield failure than screws placed in lag fashion in single cycle load-to-failure mechanical testing of repaired transverse osteotomized specimens of the medial proximal forelimb sesamoid bone.

Internal validity of inter-digital web pinching as a model for perceptual diffuse noxious inhibitory controls-induced hypoalgesia in healthy humans.

PubMed

Streff, Anouk; Michaux, Gilles; Anton, Fernand

2011-01-01

Hot and ice-water immersions are commonly used for heterotopic noxious counter-stimulation (HNCS) in investigations on endogenous pain modulation. However, coincident sympathetic thermoregulatory activity does not allow to differentiate between perceptual hypoalgesia related to baroreflex sensitivity (BRS) or diffuse noxious inhibitory controls (DNIC). The present study analysed the internal validity of another supposedly less confounded tonic pain model (inter-digital web pinching; IWP) regarding its potential as DNIC trigger. We performed a randomized controlled study in 24 healthy gender-matched drug-free volunteers aged 21-54 (median 25) years. The study protocol comprised the assessment of mechanical and thermal perceptual wind-up before and after an IWP (15N) or hot water immersion trial (HIT; 47.5°C) of 2 min duration. Wind-up was induced either by 10 repetitive (1Hz) contact heat (max. 49°C; 5×5 mm thermode) or ballistic impact stimuli (0.5g at 9 m/s) on the phalanges of the non-dominant hand. Cardiovascular activity, pain experience and corrugator muscle activity were continuously monitored. Although both HNCS forms produced a similar pain experience (45% of scale), a more pronounced cardiovascular activity was observable for the HIT (P<0.01). This indicates a higher baroreceptor activity and stronger contamination of painful water immersion by BRS-related hypoalgesia. Regardless of pain modality, wind-up was significantly reduced by HNCS, although this was stronger for painful water immersion than for noxious pinching (P<0.01). The HNCS types allow a differentiation between BRS-related and DNIC-like hypoalgesia. IWP proved its validity for DNIC induction, being practically non-confounded by BRS. Copyright © 2010 European Federation of International Association for the Study of Pain Chapters. Published by Elsevier Ltd. All rights reserved.

Bone suture anchor fixation in the lower extremity: a review of insertion principles and a comparative biomechanical evaluation.

PubMed

Scranton, Pierce E; Lawhon, S Michael; McDermott, John E

2005-07-01

Suture anchors have been developed for the fixation of ligaments, capsules, or tendons to bone. These devices have led to improved fixation, smaller incisions, earlier limb mobility, and improved outcomes. They were originally developed for use in shoulder reconstructions but are now used in almost all extremities. In the lower leg they are used in the tibia, the talus, the calcaneus, tarsal bones, and phalanges. Nevertheless, techniques for insertion and mechanisms of failure are not well described. Five suture anchors were studied to determine the pullout strength in four distal cadaver femurs and four proximal cadaver tibias from 55- and 62-year-old males. Eight hundred ninety Newton line was used, testing the anchors to failure with an Instron testing device (Instron, Norwood, MA). The anchor devices were inserted randomly and tested blindly (12 tests per anchor device, 60 tests in all). Two anchors in each group tested failed at low loads. Both types of plastic anchors had failures at the eyelet. Average pullout strength varied from 85.4 to 185.6 N. Insertion techniques are specific for each device, and they must be followed for optimal fixation. In this study, in all five groups of anchors tested two of the 12 anchors in each group failed with minimal force. On the basis of this finding we recommend that, if suture anchor fixation is necessary, at least two anchors should be used. Since there appears to be a percentage of failure in all devices, the second anchor can serve as a backup. It is imperative that surgeons be familiar with the insertion techniques of each device before use.

Shoulder injuries from alpine skiing and snowboarding. Aetiology, treatment and prevention.

PubMed

Kocher, M S; Dupré, M M; Feagin, J A

1998-03-01

There has been a decrease in the overall injury rate and the rate of lower extremity injuries for alpine skiing, with a resultant increase in the ratio of upper extremity to lower extremity injuries. Upper extremity injuries account for 20 to 35% of all injuries during alpine skiing and nearly 50% of all injuries during snowboarding. The most common upper extremity injuries during skiing are sprain of the thumb metacarpal-phalangeal joint ulnar collateral ligament, and the most common in snowboarding is wrist fracture. Shoulder injuries from skiing and snowboarding have been less well characterised. With the increased ratio of upper to lower extremity injuries during alpine skiing and the boom in popularity of snowboarding, shoulder injuries will be seen with increasing frequency by those who care for alpine sport injuries. Shoulder injuries account for 4 to 11% of all alpine skiing injuries and 22 to 41% of upper extremity injuries. The rate of shoulder injuries during alpine skiing is 0.2 to 0.5 injuries per thousand skier-days. During snowboarding, shoulder injuries account for 8 to 16% of all injuries and 20 to 34% of upper extremity injuries. Falls are the most common mechanism of shoulder injury, in addition to pole planting during skiing and aerial manoeuvres during snowboarding. Common shoulder injuries during skiing and snowboarding are glenohumeral instability, rotator cuff strains, acromioclavicular separations and clavicle fractures. Less common shoulder injuries include greater tuberosity fractures, trapezius strains, proximal humerus fractures, biceps strains, glenoid fractures, scapula fractures, humeral head fractures, sterno-clavicular separations, acromion fractures and biceps tendon dislocation. Prevention of shoulder injuries during skiing and snowboarding may be possible through interventions in education and technique, conditioning and equipment and environment.

Analysis of bone microarchitecture related to anthropometry in climateric women.

PubMed

Giolo De Carvalho, F; de Souza Santos, R; Iannetta, R; Marques Miguel Suen, V; Marliere Navarro, A; Nonino Borges, C B; Marchini, J S; Iannetta, O

2012-01-01

Osteoporosis is one of the most important public health problems involving a high percentage of costs in the medical care system. Reliable diagnostic techniques for an early detection of bone deterioration and studies of factors that influence its development in menopausal women are crucial. The aim of the study was to determine the relationship between bone microarchitecture and anthropometry in climacteric women. Women were recruited at the Menopause Clinic, University Hospital of FMRP/USP, and submitted to anthropometry and to the evaluation of bone quality (Ultrasound Bone Profile Index, UBPI) and quantity (Amplitudedependent Speed of Sound, AD-SoS-) by phalangeal quantitative osteosonography (DBM Sonic BP). Descriptive analysis of the data was reported and a multiple linear regression was performed using the software SAS® 9.0. 71 patients aged 58 ± 7 y were studied: 28% had BMI 18.5-24.9 kg/m(2), 35% BMI 24.9-29.9 and 37% BMI > 30. Mean AD-SoS was 2059 ± 79 m/s and mean UBPI was 0.67 ± 0.13. Considering AD-SoS the dependent variable, there was no statistically significant relationship between age (p = 0.20), BMI (p = 0.76), fat mass by bioelectrical impedance (p = 0.42) and by anthropometry (p = 0.95). The variables had very low effect on the UBPI when it was considered the dependent variable. The relation between bone microarchitecture and the anthropometry of the women studied shows that, the greater the bone quantity, the better the anthropometric parameters, without statistically significance. This work was a cross-sectional study on a small sample that needs to be validated in a prospective design.

De Novo Mutations in SLC25A24 Cause a Craniosynostosis Syndrome with Hypertrichosis, Progeroid Appearance, and Mitochondrial Dysfunction.

PubMed

Ehmke, Nadja; Graul-Neumann, Luitgard; Smorag, Lukasz; Koenig, Rainer; Segebrecht, Lara; Magoulas, Pilar; Scaglia, Fernando; Kilic, Esra; Hennig, Anna F; Adolphs, Nicolai; Saha, Namrata; Fauler, Beatrix; Kalscheuer, Vera M; Hennig, Friederike; Altmüller, Janine; Netzer, Christian; Thiele, Holger; Nürnberg, Peter; Yigit, Gökhan; Jäger, Marten; Hecht, Jochen; Krüger, Ulrike; Mielke, Thorsten; Krawitz, Peter M; Horn, Denise; Schuelke, Markus; Mundlos, Stefan; Bacino, Carlos A; Bonnen, Penelope E; Wollnik, Bernd; Fischer-Zirnsak, Björn; Kornak, Uwe

2017-11-02

Gorlin-Chaudhry-Moss syndrome (GCMS) is a dysmorphic syndrome characterized by coronal craniosynostosis and severe midface hypoplasia, body and facial hypertrichosis, microphthalmia, short stature, and short distal phalanges. Variable lipoatrophy and cutis laxa are the basis for a progeroid appearance. Using exome and genome sequencing, we identified the recurrent de novo mutations c.650G>A (p.Arg217His) and c.649C>T (p.Arg217Cys) in SLC25A24 in five unrelated girls diagnosed with GCMS. Two of the girls had pronounced neonatal progeroid features and were initially diagnosed with Wiedemann-Rautenstrauch syndrome. SLC25A24 encodes a mitochondrial inner membrane ATP-Mg/P i carrier. In fibroblasts from affected individuals, the mutated SLC25A24 showed normal stability. In contrast to control cells, the probands' cells showed mitochondrial swelling, which was exacerbated upon treatment with hydrogen peroxide (H 2 O 2 ). The same effect was observed after overexpression of the mutant cDNA. Under normal culture conditions, the mitochondrial membrane potential of the probands' fibroblasts was intact, whereas ATP content in the mitochondrial matrix was lower than that in control cells. However, upon H 2 O 2 exposure, the membrane potential was significantly elevated in cells harboring the mutated SLC25A24. No reduction of mitochondrial DNA copy number was observed. These findings demonstrate that mitochondrial dysfunction with increased sensitivity to oxidative stress is due to the SLC25A24 mutations. Our results suggest that the SLC25A24 mutations induce a gain of pathological function and link mitochondrial ATP-Mg/P i transport to the development of skeletal and connective tissue. Copyright © 2017 American Society of Human Genetics. All rights reserved.

A New Large Hyainailourine from the Bartonian of Europe and Its Bearings on the Evolution and Ecology of Massive Hyaenodonts (Mammalia)

PubMed Central

Solé, Floréal; Amson, Eli; Borths, Matthew; Vidalenc, Dominique; Morlo, Michael; Bastl, Katharina

2015-01-01

We describe a new large-sized species of hypercarnivorous hyainailourine–Kerberos langebadreae gen. & sp. nov.–from the Bartonian (MP16) locality of Montespieu (Tarn, France). These specimens consist of a skull, two hemimandibles and several hind limb elements (fibula, astragalus, calcaneum, metatarsals, and phalanges). Size estimates suggest K. langebadreae may have weighed up to 140 kg, revealing this species as the largest carnivorous mammal in Europe at that time. Besides its very large size, K. langebadreae possesses an interesting combination of primitive and derived features. The distinctive skull morphology of K. langebadreae reflects a powerful bite force. The postcranial elements, which are rarely associated with hyainailourine specimens, indicate an animal capable of a plantigrade stance and adapted for terrestrial locomotion. We performed the first phylogenetic analysis of hyainailourines to determine the systematic position of K. langebadreae and to understand the evolution of the group that includes other massive carnivores. The analysis demonstrates that Hemipsalodon, a North American taxon, is a hyainailourine and is closely related to European Paroxyaena. Based on this analysis we hypothesize the biogeographic history of the Hyainailourinae. The group appeared in Africa with a first migration to Europe during the Bartonian that likely included the ancestors of Kerberos, Paroxyaena and Hemipsalodon, which further dispersed into North America at this time. We propose that the hyainailourines dispersed into Europe also during the Priabonian. These migrants have no ecological equivalent in Europe during these intervals and likely did not conflict with the endemic hyaenodont proviverrines. The discovery of K. langebadreae shows that large body size appears early in the evolution of hyainailourines. Surprisingly, the late Miocene Hyainailouros shares a more recent common ancestor with small-bodied hyainailourines (below 15 kg). Finally, our study supports a close relationship between the Hyainailourinae and Apterodontinae and we propose the new clade: Hyainailouridae. PMID:26398622

Correlations between the equine metacarpophalangeal joint angulation and toe conformation in statics

PubMed Central

Hagen, Jenny; Kojah, Kaid; Geiger, Michael

2018-01-01

The angulation of the equine fetlock determines the load of associated tendons and probably their predisposition for injuries. However, it is questionable how the individual toe conformation and tendon properties interact with the dorsal metacarpophalangeal joint angle (DMPJ). Data are needed for a tangible evaluation of the equine limb conformation for more specific orthopaedic treatment. The aim was to evaluate the correlation between the DMPJ, toe conformation and cross-sectional area (CSA) of both flexor tendons; the superficial digital flexor tendon (SDFT) and deep digital flexor tendon (DDFT). Thirty Warmblood horses were available for the study. Lateromedial radiographs of the toe and fetlock and transverse ultrasound images of both flexor tendons were obtained from three zones. The DMPJ, length and angle of the phalanges and CSA SDFT/DDFT were measured. In addition, hoof angle, wither height, age, and sex were documented. Correlations were calculated using Pearson’s test. A paired t-test was used to evaluate left–right differences. Length and angle of the proximal and middle phalanx were significantly associated with the DMPJ (r = -0.28 – -0.45, p<0.001-0.04). Neither the angle of the hoof and distal phalanx nor the CSA SDFT/DDFT, showed a noticeable correlation with the DMPJ. Significant left–right differences occurred for the DMPJ (p<0.002) and the angle of the proximal and middle phalanx (p<0.01 – 0.002). A moderate negative correlation was shown between the DMPJ and wither height (r = - 0.31, p=0.04). Results represent only a specific population. The study provides only a static evaluation of a dynamic situation. In a clinical context, it might be useful to focus on the angulation and length of the pastern to evaluate the individual load affecting the DMPJ and its associated structures. These findings might be relevant for orthopaedic treatments and shoeing recommendations. PMID:29721438

The Langer-Giedion syndrome: Molecular dissection of a contiguous gene syndrome

DOE Office of Scientific and Technical Information (OSTI.GOV)

Luedecke, H.J.; Pillo, B.L.; Nardmann, J.

The tricho-rhino-phalangeal syndromes TRPS I and II, which are characterized by craniofacial dysmorphism and skeletal abnormalities, are caused by genetic defects in 8q24.1. The presence of multiple exostoses (EXT) distinguishes TRPS II (Langer-Giedion syndrome, LGS) from TRPS I. Multiple exostoses also occur as an autosomal dominant trait displaying genetic heterogeneity. One of the EXT loci maps to 8q24.1. Previously, we had determined a probe order (cen-D8S50-D8S98-D8S51-D8S67-D8S43-tel) for the Langer-Giedion syndrome chromosome region. The shortest region of deletion overlap in LGS patients is defined by D8S51 and D8S67. Interestingly, a patient with TRPS I and a large deletion was found tomore » be intact for these two loci, but deleted for more proximal loci. We have now constructed a complete yeast artificial chromosome (YAC) contig for the entire LGCR. Some of these YACs were used to perform fluorescence in situ hybridization analyses in patients with chromosomal abnormalities associated with TRPS I, TRPS II and EXT. One YAC containing D8S98 spans the translocation breakpoint in a patient with TRPS I and (8;18)(q24.11;q13.3;q21.13). The translocation breakpoint in a patient with TRPS II and t(4;8)(p15.3;q24.1) is covered by a D8S67 YAC. Interestingly, this YAC also spans the inversion breakpoint in a patient with EXT and inv(8)(p23;q24.1). The data indicate that most of the putative TRPS I gene is located between D8S98 and D8S51, that the putative EXT gene maps to D8S67, and that both genes are 1.5 Mbp apart. We are currently analyzing putative gene sequences in the vicinity of the chromosomal breakpoints.« less

Minimally Invasive and Open Distal Chevron Osteotomy for Mild to Moderate Hallux Valgus.

PubMed

Brogan, Kit; Lindisfarne, Edward; Akehurst, Harold; Farook, Usama; Shrier, Will; Palmer, Simon

2016-11-01

Minimally invasive surgical (MIS) techniques are increasingly being used in foot and ankle surgery but it is important that they are adopted only once they have been shown to be equivalent or superior to open techniques. We believe that the main advantages of MIS are found in the early postoperative period, but in order to adopt it as a technique longer-term studies are required. The aim of this study was to compare the 2-year outcomes of a third-generation MIS distal chevron osteotomy with a comparable traditional open distal chevron osteotomy for mild-moderate hallux valgus. Our null hypothesis was that the 2 techniques would yield equivalent clinical and radiographic results at 2 years. This was a retrospective cohort study. Eighty-one consecutive feet (49 MIS and 32 open distal chevron osteotomies) were followed up for a minimum 24 months (range 24-58). All patients were clinically assessed using the Manchester-Oxford Foot Questionnaire. Radiographic measures included hallux valgus angle, the intermetatarsal angle, hallux interphalangeal angle, metatarsal phalangeal joint angle, distal metatarsal articular angle, tibial sesamoid position, shape of the first metatarsal head, and plantar offset. Statistical analysis was done using Student t test or Wilcoxon rank-sum test for continuous data and Pearson chi-square test for categorical data. Clinical and radiologic postoperative scores in all domains were substantially improved in both groups (P < .001), but there was no statistically significant difference in improvement of any domain between open and MIS groups (P > .05). There were no significant differences in complications between the 2 groups ( > .5). The midterm results of this third-generation technique show that it was a safe procedure with good clinical outcomes and comparable to traditional open techniques for symptomatic mild-moderate hallux valgus. Level III, retrospective comparative study. © The Author(s) 2016.

Transcutaneous oximetry: normal values for the lower limb.

PubMed

Blake, Denise F; Young, Derelle A; Brown, Lawrence H

2014-09-01

Current guidelines for transcutaneous oximetry measurement (TCOM) for the lower limb define tissue hypoxia as a transcutaneous oxygen partial pressure < 40 mmHg. Values obtained with some newer machines and current research bring these reference values into question. To determine 'normal' TCOM values for the lower limb in healthy, non-smoking adults using the TCM400 oximeter with tc Sensor E5250. Thirty-two healthy, non-smoking volunteers had TCOM performed at six positions on the lower leg and foot. Measurements were taken with subjects lying supine breathing air, then with leg elevated and whilst breathing 100 % oxygen. Room-air TCOM values (mean mmHg, 95 % confidence interval (CI) ) were: lateral leg 41.3, CI 37.8 to 44.7; lateral malleolus 38.6, CI 34.1 to 43.1; medial malleolus 43.9, CI 40.2 to 47.6; dorsum, between first and second toe 39.3, CI 35.9 to 42.7; dorsum, proximal to fifth metatarsal-phalangeal joint 46.4, CI 43.4 to 49.3; plantar 52.3, CI 49.6 to 55.1. Using the currently accepted value of less than 40 mmHg for tissue hypoxia, 24 of our 32 'healthy' subjects had at least one air sensor reading that would have been classified as hypoxic. Seventeen subjects had TCOM values less than 100 mmHg when breathing 100 % normobaric oxygen. Normal lower limb TCOM readings using the TCOM400 with tc Sensor E5250 may be lower than 40 mmHg, used to define tissue hypoxia, but consistent with the wide range of values found in the literature. Because of the wide variability in TCOM at the different sensor sites we cannot recommend one TCOM value as indicative of tissue hypoxia. A thorough clinical assessment of the patient is essential to establish appropriateness for hyperbaric oxygen treatment, with TCOM used as an aid to help guide this decision, but not as an absolute diagnostic tool.

The Treatment of Joint Pain with Intra-articular Pulsed Radiofrequency.

PubMed

Schianchi, Pietro M; Sluijter, Menno E; Balogh, Susan E

2013-09-01

The intra-articular (IA) application of pulsed radiofrequency (PRF) for pain in small and large joints represents a recent development that has proven to be effective in many cases. We performed a retrospective study of 89 such procedures in 57 consecutive patients with chronic articular pain. The aim of this retrospective study is to evaluate the effectiveness of intraarticular PRF in a group of 57 consecutive patients with chronic joint pain. Patients with intractable joint pain for more than 6 months were treated with IA PRF 40-45V for 10-15 min in small joints and 60V for 15 min in large joints using fluoroscopic confirmation of correct needle position. A total of 28 shoulders, 40 knees, 10 trapezio-metacarpal, and 11 first metatarso-phalangeal joints were treated. Results were evaluated at 1, 2, and 5 months. The procedure was repeated after 1 month in 10 patients with initial suboptimal results. Success was defined as a reduction of pain score by at least 50%. All groups showed significant reductions in pain scores at all three follow-up visits. Success rates were higher in small joints (90% and 82%, respectively) than large ones (64% and 60%, respectively). Interestingly, IA PRF was successful in 6 out of 10 patients who had undergone previous surgery, including 3 with prosthetic joint replacement and in 6 of the 10 repeated procedures. There were no significant adverse effects or complications. IA PRF induced significant pain relief of long duration in a majority of our patients with joint pain. The exact mechanism is unclear, but may be related to the exposure of immune cells to low-strength RF fields, inducing an anti-inflammatory effect. The success rate appears to be highest in small joints. We recommend additional research including control groups to further investigate and clarify this method; our data suggest that it may represent a useful modality in the treatment of arthrogenic pain.

Use of quantitative ultrasonography in differentiating osteomalacia from osteoporosis: preliminary study.

PubMed

Luisetto, G; Camozzi, V; De Terlizzi, F

2000-04-01

The aim of this work was to use ultrasonographic technology to differentiate osteoporosis from osteomalacia on the basis of different patterns of the graphic trace. Three patients with osteomalacia and three with osteoporosis, all with the same lumbar spine bone mineral density, were studied. The velocity of the ultrasound beam in bone was measured by a DBM Sonic 1,200/I densitometer at the proximal phalanges of the hands in all the patients. The ultrasound beam velocity was measured when the first peak of the waveform reached a predetermined minimum amplitude value (amplitude-dependent speed of sound) as well as at the lowest point prior to the first and second peaks, before they reached the predetermined minimum amplitude value (first and second minimum speeds of sound). The graphic traces were further analyzed by Fourier analysis, and both the main frequency (f0) and the width of the peak centered in the f0 (full width at half maximum) were measured. The first and second minimum speeds of sound were significantly lower in the patients with osteomalacia than in the osteoporosis group. The first minimum speed of sound was 2,169 +/- 73 m/s in osteoporosis and 1,983 +/- 61 m/s in osteomalacia (P < 0.0001); the second minimum peak speed of sound was 1,895 +/-59 m/s in osteoporosis and 1,748 +/- 38 m/s in osteomalacia (P < 0.0001). The f0 was similar in the two groups (osteoporosis, 0.85 +/- 0.14 MHz; osteomalacia, 0.9 +/- 0.22 MHz; P = 0.72), and the full width at half maximum was significantly higher in the osteomalacia patients (0.52 +/- 0.14 MHz) than in the osteoporosis patients (0.37 +/- 0.15 MHz) (P = 0.022). This study confirms that ultrasonography is a promising, noninvasive method that could be used to differentiate osteoporosis from osteomalacia, but further studies should be carried out before this method can be introduced into clinical practice.

Peripheral Quantitative CT (pQCT) Using a Dedicated Extremity Cone-Beam CT Scanner

PubMed Central

Muhit, A. A.; Arora, S.; Ogawa, M.; Ding, Y.; Zbijewski, W.; Stayman, J. W.; Thawait, G.; Packard, N.; Senn, R.; Yang, D.; Yorkston, J.; Bingham, C.O.; Means, K.; Carrino, J. A.; Siewerdsen, J. H.

2014-01-01

Purpose We describe the initial assessment of the peripheral quantitative CT (pQCT) imaging capabilities of a cone-beam CT (CBCT) scanner dedicated to musculoskeletal extremity imaging. The aim is to accurately measure and quantify bone and joint morphology using information automatically acquired with each CBCT scan, thereby reducing the need for a separate pQCT exam. Methods A prototype CBCT scanner providing isotropic, sub-millimeter spatial resolution and soft-tissue contrast resolution comparable or superior to standard multi-detector CT (MDCT) has been developed for extremity imaging, including the capability for weight-bearing exams and multi-mode (radiography, fluoroscopy, and volumetric) imaging. Assessment of pQCT performance included measurement of bone mineral density (BMD), morphometric parameters of subchondral bone architecture, and joint space analysis. Measurements employed phantoms, cadavers, and patients from an ongoing pilot study imaged with the CBCT prototype (at various acquisition, calibration, and reconstruction techniques) in comparison to MDCT (using pQCT protocols for analysis of BMD) and micro-CT (for analysis of subchondral morphometry). Results The CBCT extremity scanner yielded BMD measurement within ±2–3% error in both phantom studies and cadaver extremity specimens. Subchondral bone architecture (bone volume fraction, trabecular thickness, degree of anisotropy, and structure model index) exhibited good correlation with gold standard micro-CT (error ~5%), surpassing the conventional limitations of spatial resolution in clinical MDCT scanners. Joint space analysis demonstrated the potential for sensitive 3D joint space mapping beyond that of qualitative radiographic scores in application to non-weight-bearing versus weight-bearing lower extremities and assessment of phalangeal joint space integrity in the upper extremities. Conclusion The CBCT extremity scanner demonstrated promising initial results in accurate pQCT analysis from images acquired with each CBCT scan. Future studies will include improved x-ray scatter correction and image reconstruction techniques to further improve accuracy and to correlate pQCT metrics with known pathology. PMID:25076823

Metatarsal head resurfacing arthroplasty in the treatment of hallux rigidus: is it reliable treatment option?

PubMed

Circi, E; Tuzuner, T; Sukur, E; Baris, A; Kanay, E

2016-08-01

This study looks at the failure and complications arising secondary to resurfacing and hemi-arthroplasty done at the metatarsal head in patients with hallux rigidus. Our report includes a review of the relevant literature to verify the validity of our techniques. We performed metatarsal head resurfacing with hemi-arthroplasty using the HemiCap(®), on 12 patients with hallux rigidus between the dates of March 2010 and October 2013. The mean follow-up period was 22.3 months (range 12-54). All patients were clinically and radiologically evaluated according to the American Orthopedics Foot and Ankle Society (AOFAS) functional scale and the Coughlin and Shurnas classification. The recorded mean AOFAS score showed an increase from the preoperative score of 49.2 ± 13.1 to a postoperative follow-up score of 80.8 ± 13.1 (p < 0.001). Pain scores also showed an improvement from 16.5 ± 7.1 points preoperatively to 32.5 ± 6.9 points during the postoperative follow-up (p < 0.001). The mean function score improved from 17.7 ± 7.6 points preoperatively to 33.2 ± 7.6 points during the final postoperative follow-up (p < 0.001). Furthermore, the mean range of motion improved from 16.3 ± 4.8° preoperatively to 45.4 ± 13.2° postoperatively (p < 0.001). Three patients (25 %) reported pain at rest. Surgical revision was done on these patients who have significant pain that limited their range of motion. Favorable outcomes were achieved by performing minimal bone resection which also helps maintain metatarso-phalangeal joint function through metatarsal head resurfacing arthroplasty. We expect the failure rates to decrease with the advancements of surgical techniques. Selecting the appropriate patient populous in the application of the technique is crucial in attaining successful clinical results.

Fractures and dislocations of the hand in polytrauma patients: Incidence, injury pattern and functional outcome.

PubMed

Ferree, Steven; van der Vliet, Quirine M J; van Heijl, Mark; Houwert, Roderick M; Leenen, Luke P H; Hietbrink, Falco

2017-04-01

Injuries of the hand can cause significant functional impairment, diminished quality of life and delayed return to work. However, the incidence and functional outcome of hand injuries in polytrauma patients is currently unknown. The aim of this study was to determine the incidence, distribution and functional outcome of fractures and dislocation of the hand in polytrauma patients. A single centre retrospective cohort study was performed at a level 1 trauma centre. Polytrauma was defined as patients with an Injury Severity Score of 16 or higher. Fractures and dislocations to the hand were determined. All eligible polytrauma patients with hand injuries were included and a Quick Disability of Arm, Shoulder and Hand questionnaire (QDASH) and Patient-Rated Wrist/Hand Evaluation (PRWHE) were administered. Patients were contacted 1-6 years after trauma. In a cohort of 2046 polytrauma patients 72 patients (3.5%) suffered a hand injury. The functional outcome scores of 52 patients (72%) were obtained. The Metacarpal (48%) and carpal (33%) bones were the most frequently affected. The median QDASH score for all patients with hand injury was 17 (IQR 0-31) and the PRWHE 14 (IQR 0-41). Patients with a concomitant upper extremity injury (p=0.002 for PRWHE, p0.006 for QDASH) and those with higher ISS scores (p=0.034 for PRWHE, QDASH not significant) had worse functional outcome scores. As an example, of the 5 patients with the worst outcome scores 3 suffered an isolated phalangeal injury, all had concomitant upper extremity injury or neurological injuries (3 plexus injuries, 1 severe brain injury). The incidence of hand injuries in polytrauma patients is 3.5%, which is relatively low compared to a general trauma population. Metacarpal and carpal bones were most frequently affected. The functional extremity specific outcome scores are highly influenced by concomitant injuries (upper extremity injuries, neurological injuries and higher ISS). Copyright © 2017 Elsevier Ltd. All rights reserved.

Qualitative skeletal correlates of wing shape in extant birds (Aves: Neoaves).

PubMed

Hieronymus, Tobin L

2015-02-27

Among living fliers (birds, bats, and insects), birds display relatively high aspect ratios, a dimensionless shape variable that distinguishes long and narrow vs. short and broad wings. Increasing aspect ratio results in a functional tradeoff between low induced drag (efficient cruise) and increased wing inertia (difficult takeoff). Given the wide scope of its functional effects, the pattern of aspect ratio evolution is an important factor that contributes to the substantial ecological and phylogenetic diversity of living birds. However, because the feathers that define the wingtip (and hence wingspan and aspect ratio) often do not fossilize, resolution in the pattern of avian wing shape evolution is obscured by missing information. Here I use a comparative approach to investigate the relationship between skeletal proxies of flight feather attachment and wing shape. An accessory lobe of the internal index process of digit II-1, a bony correlate of distal primary attachment, shows weak but statistically significant relationships to aspect ratio and mass independent of other skeletal morphology. The dorsal phalangeal fossae of digit II-1, which house distal primaries VIII and IX, also show a trend of increased prominence with higher aspect ratio. Quill knobs on the ulna are examined concurrently, but do not show consistent signal with respect to wing shape. Although quill knobs are cited as skeletal correlates of flight performance in birds, their relationship to wing shape is inconsistent among extant taxa, and may reflect diverging selection pressures acting on a conserved architecture. In contrast, correlates of distal primary feather attachment on the major digit show convergent responses to increasing aspect ratio. In light of the diversity of musculoskeletal and integumentary mophology that underlies wing shape in different avian clades, it is unlikely that a single skeletal feature will show consistent predictive power across Neoaves. Confident inference of wing shape in basal ornithurine birds will require multiple lines of evidence, together with an understanding of clade-specific evolutionary trends within the crown.

Distinct Inter-Joint Coordination during Fast Alternate Keystrokes in Pianists with Superior Skill.

PubMed

Furuya, Shinichi; Goda, Tatsushi; Katayose, Haruhiro; Miwa, Hiroyoshi; Nagata, Noriko

2011-01-01

Musical performance requires motor skills to coordinate the movements of multiple joints in the hand and arm over a wide range of tempi. However, it is unclear whether the coordination of movement across joints would differ for musicians with different skill levels and how inter-joint coordination would vary in relation to music tempo. The present study addresses these issues by examining the kinematics and muscular activity of the hand and arm movements of professional and amateur pianists who strike two keys alternately with the thumb and little finger at various tempi. The professionals produced a smaller flexion velocity at the thumb and little finger and greater elbow pronation and supination velocity than did the amateurs. The experts also showed smaller extension angles at the metacarpo-phalangeal joint of the index and middle fingers, which were not being used to strike the keys. Furthermore, muscular activity in the extrinsic finger muscles was smaller for the experts than for the amateurs. These findings indicate that pianists with superior skill reduce the finger muscle load during keystrokes by taking advantage of differences in proximal joint motion and hand postural configuration. With an increase in tempo, the experts showed larger and smaller increases in elbow velocity and finger muscle co-activation, respectively, compared to the amateurs, highlighting skill level-dependent differences in movement strategies for tempo adjustment. Finally, when striking as fast as possible, individual differences in the striking tempo among players were explained by their elbow velocities but not by their digit velocities. These findings suggest that pianists who are capable of faster keystrokes benefit more from proximal joint motion than do pianists who are not capable of faster keystrokes. The distinct movement strategy for tempo adjustment in pianists with superior skill would therefore ensure a wider range of musical expression.

Distinct Inter-Joint Coordination during Fast Alternate Keystrokes in Pianists with Superior Skill

PubMed Central

Furuya, Shinichi; Goda, Tatsushi; Katayose, Haruhiro; Miwa, Hiroyoshi; Nagata, Noriko

2011-01-01

Musical performance requires motor skills to coordinate the movements of multiple joints in the hand and arm over a wide range of tempi. However, it is unclear whether the coordination of movement across joints would differ for musicians with different skill levels and how inter-joint coordination would vary in relation to music tempo. The present study addresses these issues by examining the kinematics and muscular activity of the hand and arm movements of professional and amateur pianists who strike two keys alternately with the thumb and little finger at various tempi. The professionals produced a smaller flexion velocity at the thumb and little finger and greater elbow pronation and supination velocity than did the amateurs. The experts also showed smaller extension angles at the metacarpo-phalangeal joint of the index and middle fingers, which were not being used to strike the keys. Furthermore, muscular activity in the extrinsic finger muscles was smaller for the experts than for the amateurs. These findings indicate that pianists with superior skill reduce the finger muscle load during keystrokes by taking advantage of differences in proximal joint motion and hand postural configuration. With an increase in tempo, the experts showed larger and smaller increases in elbow velocity and finger muscle co-activation, respectively, compared to the amateurs, highlighting skill level-dependent differences in movement strategies for tempo adjustment. Finally, when striking as fast as possible, individual differences in the striking tempo among players were explained by their elbow velocities but not by their digit velocities. These findings suggest that pianists who are capable of faster keystrokes benefit more from proximal joint motion than do pianists who are not capable of faster keystrokes. The distinct movement strategy for tempo adjustment in pianists with superior skill would therefore ensure a wider range of musical expression. PMID:21660290

Limited independent flexion of the thumb and fingers in human subjects.

PubMed Central

Kilbreath, S L; Gandevia, S C

1994-01-01

1. We investigated whether human subjects can activate selectively flexor pollicis longus (FPL) and digital portions of flexor digitorum profundus (FDP). These muscles were selected because they are the only flexors of the distal phalanges. 2. Electromyographic activity (EMG) was recorded with intramuscular electrodes from one digital component of the deep flexors ('test') while subjects lifted weights by flexing the distal interphalangeal joint of the other digits in turn ('lifting' digits). Only recording sites at which single motor units were recruited selectively at low forces were used. The weights lifted represented 2.5-50% of the maximal voluntary contraction (MVC). We measured the lowest weight lifted which produced phasic and tonic coactivation in the 'test' muscle. 3. The extent of coactivation varied with the 'distance' between the test and lifting digits although no significant difference occurred in the pattern of coactivation thresholds among the digital flexors. The extent of coactivation increased when angular displacement or velocity at the distal interphalangeal joint of the lifting digit increased but was not critically dependent on restraint of the hand. 4. Because mechanical 'connections' could interfere with the ability to move a distal phalanx independently, the arms of nine cadavers were studied. The separation of tendons between the thumb (FPL) and the index portion of FDP, and between the index and middle portions of FDP, usually extended more proximally in the forearm than separation between the tendons to the middle and ring fingers and between the ring and little fingers. Direct intertendinous links were also noted. 5. It is not possible to direct a sufficiently focal motor command to flex selectively the distal joint of the fingers and thumb when forces exceeding 2.5% MVC are generated. For the middle, ring and little fingers in particular, movement of adjacent digits may also involve 'in-series' mechanical links between adjacent components of FDP. Images Figure 6 PMID:7837104

The use of a magnesium-based bone adhesive for flexor tendon-to-bone healing

PubMed Central

Stavros, Thomopoulos; Emmanouil, Zampiakis; Rosalina, Das; Hyun-Min, Kim; J., Silva, Matthew; Necat, Havlioglu; H., Gelberman, Richard

2010-01-01

Purpose Our previous studies in a canine animal model demonstrated that the flexor tendon-to-bone insertion site has a poor capacity to heal. Magnesium based adhesives have the potential to improve tendon-to-bone healing. Therefore, we hypothesized that magnesium based bone adhesive (MBA) will improve the tendon-to-bone biomechanical properties initially and in the early period after repair. Methods Flexor digitorum profundus tendons were injured and repaired into bone tunnels in the distal phalanges of dogs. The bone tunnels were either filled with MBA prior to completing the repair or left empty (CTL). Histologic appearance, tensile properties, range of motion, and bone density were examined at time zero and 21 days after the repair. Results There was no histologic evidence of acute inflammation. There appeared to be more mast cells in the MBA group than in the CTL group. Chronic inflammatory infiltrate and fibrosis was slightly higher in the MBA group compared to the CTL group. Tensile properties at time zero were significantly higher in the MBA group compared to the CTL group. However, tensile properties were significantly lower in the MBA group compared to the CTL group at 21 days. Range of motion and bone density were significantly lower in the MBA and CTL groups compared to normal (i.e., uninjured) at 21 days; no differences were seen when comparing MBA to CTL. Conclusions We found that the initial biomechanical properties of flexor tendon-to-bone repairs can be improved with MBA. However, MBA use in vivo led to a decrease in the biomechanical properties of the repair. There was no effect of MBA on bone density or range of motion in the early period after repair. Our histologic analysis suggests that the poor healing in the MBA group may have been due to an allergic response or to increased chronic inflammation due to the foreign material. PMID:19643291

Foot orgasm syndrome: a case report in a woman.

PubMed

Waldinger, Marcel D; de Lint, Govert J; van Gils, Ad P G; Masir, Farhad; Lakke, Egbert; van Coevorden, Ruben S; Schweitzer, Dave H

2013-08-01

Spontaneous orgasm triggered from inside the foot has so far not been reported in medical literature. The study aims to report orgasmic feelings in the left foot of a woman. A woman presented with complaints of undesired orgasmic sensations originating in her left foot. In-depth interview, physical examination, sensory testing, magnetic resonance imaging (MRI-scan), electromyography (EMG), transcutaneous electrical nerve stimulation (TENS), and blockade of the left S1 dorsal root ganglion were performed. The main outcomes are description of this clinical syndrome, results of TENS application, and S1 dorsal root ganglion blockade. Subtle attenuation of sensory amplitudes of the left suralis, and the left medial and lateral plantar nerve tracts was found at EMG. MRI-scan disclosed no foot abnormalities. TENS at the left metatarso-phalangeal joint-III of the left foot elicited an instant orgasmic sensation that radiated from plantar toward the vagina. TENS applied to the left side of the vagina elicited an orgasm that radiated to the left foot. Diagnostic blockade of the left S1 dorsal root ganglion with 0.8 mL bupivacaine 0.25 mg attenuated the frequency and intensity of orgasmic sensation in the left foot with 50% and 80%, respectively. Additional therapeutic blockade of the same ganglion with 0.8 mL bupivacaine 0.50 mg combined with pulsed radiofrequency treatment resulted in a complete disappearance of the foot-induced orgasmic sensations. Foot orgasm syndrome (FOS) is descibed in a woman. Blockade of the left S1 dorsal root ganglion alleviated FOS. It is hypothesized that FOS, occurring 1.5 years after an intensive care emergency, was caused by partial nerve regeneration (axonotmesis), after which afferent (C-fiber) information from a small reinnervated skin area of the left foot and afferent somatic and autonomous (visceral) information from the vagina on at least S1 spinal level is misinterpreted by the brain as being solely information originating from the vagina. © 2013 International Society for Sexual Medicine.

Risk of Prolonged Opioid Use Among Opioid-Naïve Patients Following Common Hand Surgery Procedures.

PubMed

Johnson, Shepard P; Chung, Kevin C; Zhong, Lin; Shauver, Melissa J; Engelsbe, Michael J; Brummett, Chad; Waljee, Jennifer F

2016-10-01

To evaluate prolonged opioid use in opioid-naïve patients after common hand surgery procedures in the United States. We studied insurance claims from the Truven MarketScan databases to identify opioid-naïve adult patients (no opioid exposure 11 months before the perioperative period) who underwent an elective (carpal tunnel release, carpometacarpal arthroplasty/arthrodesis, cubital tunnel release, or trigger finger release) or trauma-related (closed distal radius fracture fixation, flexor tendon repair, metacarpal fracture fixation, or phalangeal fracture fixation) hand surgery procedure between 2010 and 2012 (N = 77,573 patients). Patients were observed for 6 months to determine the number, timing, duration, and oral morphine equivalent dosage of postoperative opioid prescriptions. We assessed prolonged postoperative opioid use, defined as patients who filled a perioperative opioid prescription followed by a prescription between 90 and 180 days after surgery, and evaluated associated risk factors using multivariable logistic regression. In this cohort, 59,725 opioid-naïve patients (77%) filled a perioperative opioid prescription. Of these, 13% of patients continued to fill prescriptions between 90 and 180 days after surgery. Elective surgery patients were more likely to continue to fill opioid prescriptions after 90 days compared with trauma patients (13.5% vs 10.5%). Younger age, female gender, lower income, comprehensive insurance, higher Elixhauser comorbidity index, mental health disorders, and tobacco dependence or abuse were associated with prolonged opioid use. Approximately 13% of opioid-naïve patients continue to fill opioid prescriptions after hand surgery procedures 90 days after surgery. Preoperative interventions centered on opioid alternatives and early cessation, particularly among patients at risk for long-term use, is critical to addressing the prescription opioid crisis in the United States. The current national opioid use epidemic requires an assessment of the prevalence of hand surgery patients who receive and fill opioid prescriptions after common hand surgery procedures. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Modeling and stress analyses of a normal foot-ankle and a prosthetic foot-ankle complex.

PubMed

Ozen, Mustafa; Sayman, Onur; Havitcioglu, Hasan

2013-01-01

Total ankle replacement (TAR) is a relatively new concept and is becoming more popular for treatment of ankle arthritis and fractures. Because of the high costs and difficulties of experimental studies, the developments of TAR prostheses are progressing very slowly. For this reason, the medical imaging techniques such as CT, and MR have become more and more useful. The finite element method (FEM) is a widely used technique to estimate the mechanical behaviors of materials and structures in engineering applications. FEM has also been increasingly applied to biomechanical analyses of human bones, tissues and organs, thanks to the development of both the computing capabilities and the medical imaging techniques. 3-D finite element models of the human foot and ankle from reconstruction of MR and CT images have been investigated by some authors. In this study, data of geometries (used in modeling) of a normal and a prosthetic foot and ankle were obtained from a 3D reconstruction of CT images. The segmentation software, MIMICS was used to generate the 3D images of the bony structures, soft tissues and components of prosthesis of normal and prosthetic ankle-foot complex. Except the spaces between the adjacent surface of the phalanges fused, metatarsals, cuneiforms, cuboid, navicular, talus and calcaneus bones, soft tissues and components of prosthesis were independently developed to form foot and ankle complex. SOLIDWORKS program was used to form the boundary surfaces of all model components and then the solid models were obtained from these boundary surfaces. Finite element analyses software, ABAQUS was used to perform the numerical stress analyses of these models for balanced standing position. Plantar pressure and von Mises stress distributions of the normal and prosthetic ankles were compared with each other. There was a peak pressure increase at the 4th metatarsal, first metatarsal and talus bones and a decrease at the intermediate cuneiform and calcaneus bones, in prosthetic ankle-foot complex compared to normal one. The predicted plantar pressures and von Misses stress distributions for a normal foot were consistent with other FE models given in the literature. The present study is aimed to open new approaches for the development of ankle prosthesis.

Radiographic angles in hallux valgus: differences between measurements made manually and with a computerized program.

PubMed

Piqué-Vidal, Carlos; Maled-García, Ignaci; Arabi-Moreno, Juanjo; Vila, Joan

2006-03-01

The objective of this study was to compare angular measurements in the evaluation of hallux valgus deformities using a goniometer and a computerized program to assess degree of concordance between the two methods and determine the reliability of manual measurements. Angles measured included the hallux valgus angle (HVA), the intermetatarsal angle (IMA), the distal metatarsal articular angle (DMAA), and the proximal phalangeal articular angle (PPAA), also called the hallux valgus interphalangeus angle or interphalangeal angle. Measurements were made on preoperative weightbearing radiographs in 176 patients with symptomatic hallux valgus. Manual measurements were made with a goniometer by an orthopaedic surgeon. An independent experienced technician used digitized images to perform angular measurements with the Autocad software program (Autodesk Inc., San Rafael, CA). HVA values obtained with the two techniques were similar. However, significantly higher mean values were obtained with the Autocad for the IMA and PPAA measurements, and higher mean values were obtained for the DMAA measurement with the manual technique. Whereas differences were more or less randomly distributed for the HVA, in the remaining patients, measurements were clearly related to the measurement technique, i.e., for the DMAA, the manual technique had a tendency to show higher values, and for the IMA and PPAA the manual technique showed lower values than the computer. Correlations between both techniques for the different angular measurements were as follows: HVA, -0.179 (p = 0.018); DMMA, -0.294 (p < 0.001); PPAA, -0.876 (p < 0.001); and IMA, -0.661 (p < 0.001). The intraclass correlation coefficient (ICC) showed that the concordance between manual and Autocad angular measurements was excellent for the HVA (ICC = 0.89) and DMAA (ICC = 0.80) and very poor for the PPAA (ICC = 0.11) and IMA (ICC = 0.42). Angular measurements made on weightbearing radiographs with the Autocad in patients with hallux valgus deformities were more reliable than those made with a goniometer. Although for large angles, such as HVA and DMAA, results obtained with both measurement techniques were similar. Manual measurements, however, may underestimate the true values of the smaller IMA and PPAA angles.

How the pterosaur got its wings.

PubMed

Tokita, Masayoshi

2015-11-01

Throughout the evolutionary history of life, only three vertebrate lineages took to the air by acquiring a body plan suitable for powered flight: birds, bats, and pterosaurs. Because pterosaurs were the earliest vertebrate lineage capable of powered flight and included the largest volant animal in the history of the earth, understanding how they evolved their flight apparatus, the wing, is an important issue in evolutionary biology. Herein, I speculate on the potential basis of pterosaur wing evolution using recent advances in the developmental biology of flying and non-flying vertebrates. The most significant morphological features of pterosaur wings are: (i) a disproportionately elongated fourth finger, and (ii) a wing membrane called the brachiopatagium, which stretches from the posterior surface of the arm and elongated fourth finger to the anterior surface of the leg. At limb-forming stages of pterosaur embryos, the zone of polarizing activity (ZPA) cells, from which the fourth finger eventually differentiates, could up-regulate, restrict, and prolong expression of 5'-located Homeobox D (Hoxd) genes (e.g. Hoxd11, Hoxd12, and Hoxd13) around the ZPA through pterosaur-specific exploitation of sonic hedgehog (SHH) signalling. 5'Hoxd genes could then influence downstream bone morphogenetic protein (BMP) signalling to facilitate chondrocyte proliferation in long bones. Potential expression of Fgf10 and Tbx3 in the primordium of the brachiopatagium formed posterior to the forelimb bud might also facilitate elongation of the phalanges of the fourth finger. To establish the flight-adapted musculoskeletal morphology shared by all volant vertebrates, pterosaurs probably underwent regulatory changes in the expression of genes controlling forelimb and pectoral girdle musculoskeletal development (e.g. Tbx5), as well as certain changes in the mode of cell-cell interactions between muscular and connective tissues in the early phase of their evolution. Developmental data now accumulating for extant vertebrate taxa could be helpful in understanding the cellular and molecular mechanisms of body-plan evolution in extinct vertebrates as well as extant vertebrates with unique morphology whose embryonic materials are hard to obtain. © 2014 The Author. Biological Reviews © 2014 Cambridge Philosophical Society.

Running stability is enhanced by a proximo-distal gradient in joint neuromechanical control.

PubMed

Daley, M A; Felix, G; Biewener, A A

2007-02-01

We currently know little about how animals achieve dynamic stability when running over uneven and unpredictable terrain, often characteristic of their natural environment. Here we investigate how limb and joint mechanics of an avian biped, the helmeted guinea fowl Numida meleagris, respond to an unexpected drop in terrain during running. In particular, we address how joint mechanics are coordinated to achieve whole limb dynamics. Based on muscle-tendon architecture and previous studies of steady and incline locomotion, we hypothesize a proximo-distal gradient in joint neuromechanical control. In this motor control strategy, (1) proximal muscles at the hip and knee joints are controlled primarily in a feedforward manner and exhibit load-insensitive mechanical performance, and (2) distal muscles at the ankle and tarsometatarso-phalangeal (TMP) joints are highly load-sensitive, due to intrinsic mechanical effects and rapid, higher gain proprioceptive feedback. Limb kinematics and kinetics during the unexpected perturbation reveal that limb retraction, controlled largely by the hip, remains similar to level running throughout the perturbed step, despite altered limb loading. Individual joints produce or absorb energy during both level and perturbed running steps, such that the net limb work depends on the balance of energy among the joints. The hip maintains the same mechanical role regardless of limb loading, whereas the ankle and TMP switch between spring-like or damping function depending on limb posture at ground contact. Initial knee angle sets limb posture and alters the balance of work among the joints, although the knee contributes little work itself. This distribution of joint function results in posture-dependent changes in work performance of the limb, which allow guinea fowl to rapidly produce or absorb energy in response to the perturbation. The results support the hypothesis that a proximo-distal gradient exists in limb neuromuscular performance and motor control. This control strategy allows limb cycling to remain constant, whereas limb posture, loading and energy performance are interdependent. We propose that this control strategy provides simple, rapid mechanisms for managing energy and controlling velocity when running over rough terrain.

Hand trauma: A prospective observational study reporting diagnostic concordance in emergency hand trauma which supports centralised service improvements.

PubMed

Miranda, B H; Spilsbury, Z P; Rosala-Hallas, A; Cerovac, S

2016-10-01

Hand injuries are common, contributing up to 30% of accident and emergency (A&E) attendances. The aim of this study was to prospectively analyse the pathological demographics of hand injuries in a level 1 trauma centre with a Hand Trauma Unit and direct A&E links, and compare clinical and intra-operative findings. The null hypothesis was that there would be no differences between clinical and intra-operative findings (100% diagnostic concordance). Data were prospectively collected for referrals during 2012. Referral diagnosis, additional pathologies found on clinical assessment and intra-operative findings were documented on a live database accessible from both the Hand Unit and associated operating theatres. Odds ratios were calculated using SAS. Injuries (1526) were identified in 1308 patients included in the study. Diagnostic concordance between Hand Unit clinical examination and intra-operative findings was 92.5% ± 2.85% (mean ± SEM); this was lower for flexor tendon injuries (56.3%) because a greater number of additional pathologies were found intra-operatively (2.25 ± 0.10). This 'trend' was noted across multiple referral pathologies including phalangeal fractures (1.28 ± 0.02; 82.9%), lacerations (1.33 ± 0.04; 79.1%), extensor tendon injuries (1.30 ± 0.05; 87.8%) and dislocations (1.18 ± 0.05; 87.8%). Odds ratio analysis indicated a relationship between primary referral diagnoses that were more or less likely to be associated with additional injuries (p < 0.05); referral diagnoses of flexor tendon injuries and lacerations were most likely to be associated with additional injuries. As hand injuries are a common presentation to A&E departments, greater emphasis should be placed on training clinicians in the management of hand trauma. Our findings, coupled with the presented relevant literature reports, lead us to advocate that A&E departments should move towards a system wherein links to specialist hand trauma services are in place; we hereby present useful data for hospitals implementing such services. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

Running stability is enhanced by a proximo-distal gradient in joint neuromechanical control

PubMed Central

Daley, M. A.; Felix, G.; Biewener, A. A.

2008-01-01

Summary We currently know little about how animals achieve dynamic stability when running over uneven and unpredictable terrain, often characteristic of their natural environment. Here we investigate how limb and joint mechanics of an avian biped, the helmeted guinea fowl Numida meleagris, respond to an unexpected drop in terrain during running. In particular, we address how joint mechanics are coordinated to achieve whole limb dynamics. Based on muscle–tendon architecture and previous studies of steady and incline locomotion, we hypothesize a proximo-distal gradient in joint neuromechanical control. In this motor control strategy, (1) proximal muscles at the hip and knee joints are controlled primarily in a feedforward manner and exhibit load-insensitive mechanical performance, and (2) distal muscles at the ankle and tarsometatarso-phalangeal (TMP) joints are highly load-sensitive, due to intrinsic mechanical effects and rapid, higher gain proprioceptive feedback. Limb kinematics and kinetics during the unexpected perturbation reveal that limb retraction, controlled largely by the hip, remains similar to level running throughout the perturbed step, despite altered limb loading. Individual joints produce or absorb energy during both level and perturbed running steps, such that the net limb work depends on the balance of energy among the joints. The hip maintains the same mechanical role regardless of limb loading, whereas the ankle and TMP switch between spring-like or damping function depending on limb posture at ground contact. Initial knee angle sets limb posture and alters the balance of work among the joints, although the knee contributes little work itself. This distribution of joint function results in posture-dependent changes in work performance of the limb, which allow guinea fowl to rapidly produce or absorb energy in response to the perturbation. The results support the hypothesis that a proximo-distal gradient exists in limb neuromuscular performance and motor control. This control strategy allows limb cycling to remain constant, whereas limb posture, loading and energy performance are interdependent. We propose that this control strategy provides simple, rapid mechanisms for managing energy and controlling velocity when running over rough terrain. PMID:17234607

Trps1 deficiency inhibits the morphogenesis of secondary hair follicles via decreased Noggin expression

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sun, Yujing; Nakanishi, Masako; Sato, Fuyuki

Highlights: • The number of secondary hair follicles is reduced by half in Trps1 KO embryonic skin compared to wild-type skin. • Noggin expression is significantly decreased and BMP signaling is promoted in Trps1 KO embryonic skin. • Treatment with a Noggin or BMP inhibitor rescued the decreased number of hair follicles in Trps1 KO skin graft cultures. • Cell proliferation and apoptosis of the epidermis were normalized by Noggin treatment. - Abstract: A representative phenotype of patients with tricho-rhino-phalangeal syndrome (TRPS) is sparse hair. To understand the developmental defects of these patient’s hair follicles, we analyzed the development ofmore » hair follicles histologically and biochemically using Trps1 deficient (KO) mice. First, we compared the numbers of primary hair follicles in wild-type (WT) and KO embryos at different developmental stages. No differences were observed in the E14.5 skins of WT and KO mice. However, at later time points, KO fetal skin failed to properly develop secondary hair follicles, and the number of secondary hair follicles present in E18.5 KO skin was approximately half compared to that of WT skin. Sonic hedgehog expression was significantly decreased in E17.5 KO skin, whereas no changes were observed in Eda/Edar expression in E14.5 or E17.5 skins. In addition, Noggin expression was significantly decreased in E14.5 and E17.5 KO skin compared to WT skin. In parallel with the suppression of Noggin expression, BMP signaling was promoted in the epidermal cells of KO skins compared to WT skins as determined by immunohistochemistry for phosphorylated Smad1/5/8. The reduced number of secondary hair follicles was restored in skin graft cultures treated with a Noggin and BMP inhibitor. Furthermore, decreased cell proliferation, and increased apoptosis in KO skin was rescued by Noggin treatment. Taken together, we conclude that hair follicle development in Trps1 KO embryos is impaired directly or indirectly by decreased Noggin expression.« less

Mechanical stimulation enhances integration in an in vitro model of cartilage repair.

PubMed

Theodoropoulos, John S; DeCroos, Amritha J N; Petrera, Massimo; Park, Sam; Kandel, Rita A

2016-06-01

(1) To characterize the effects of mechanical stimulation on the integration of a tissue-engineered construct in terms of histology, biochemistry and biomechanical properties; (2) to identify whether cells of the implant or host tissue were critical to implant integration; and (3) to study cells believed to be involved in lateral integration of tissue-engineered cartilage to host cartilage. We hypothesized that mechanical stimulation would enhance the integration of the repair implant with host cartilage in an in vitro integration model. Articular cartilage was harvested from 6- to 9-month-old bovine metacarpal-phalangeal joints. Constructs composed of tissue-engineered cartilage implanted into host cartilage were placed in spinner bioreactors and maintained on a magnetic stir plate at either 0 (static control) or 90 (experimental) rotations per minute (RPM). The constructs from both the static and spinner bioreactors were harvested after either 2 or 4 weeks of culture and evaluated histologically, biochemically, biomechanically and for gene expression. The extent and strength of integration between tissue-engineered cartilage and native cartilage improved significantly with both time and mechanical stimulation. Integration did not occur if the implant was not viable. The presence of stimulation led to a significant increase in collagen content in the integration zone between host and implant at 2 weeks. The gene profile of cells in the integration zone differs from host cartilage demonstrating an increase in the expression of membrane type 1 matrix metalloproteinase (MT1-MMP), aggrecan and type II collagen. This study shows that the integration of in vitro tissue-engineered implants with host tissue improves with mechanical stimulation. The findings of this study suggests that consideration should be given to implementing early loading (mechanical stimulation) into future in vivo studies investigating the long-term viability and integration of tissue-engineered cartilage for the treatment of cartilage injuries. This could simply be done through the use of continuous passive motion (CPM) in the post-operative period or through a more complex and structured rehabilitation program with a gradual increase in forces across the joint over time.

An Approach for Performance Assessments of Extravehicular Activity Gloves

NASA Technical Reports Server (NTRS)

Aitchison, Lindsay; Benosn, Elizabeth

2014-01-01

The Space Suit Assembly (SSA) Development Team at NASA Johnson Space Center has invested heavily in the advancement of rear-entry planetary exploration suit design but largely deferred development of extravehicular activity (EVA) glove designs, and accepted the risk of using the current flight gloves, Phase VI, for unique mission scenarios outside the Space Shuttle and International Space Station (ISS) Program realm of experience. However, as design reference missions mature, the risks of using heritage hardware have highlighted the need for developing robust new glove technologies. To address the technology gap, the NASA Game-Changing Technology group provided start-up funding for the High Performance EVA Glove (HPEG) Project in the spring of 2012. The overarching goal of the HPEG Project is to develop a robust glove design that increases human performance during EVA and creates pathway for future implementation of emergent technologies, with specific aims of increasing pressurized mobility to 60% of barehanded capability, increasing the durability by 100%, and decreasing the potential of gloves to cause injury during use. The HPEG Project focused initial efforts on identifying potential new technologies and benchmarking the performance of current state of the art gloves to identify trends in design and fit leading to establish standards and metrics against which emerging technologies can be assessed at both the component and assembly levels. The first of the benchmarking tests evaluated the quantitative mobility performance and subjective fit of two sets of prototype EVA gloves developed ILC Dover and David Clark Company as compared to the Phase VI. Both companies were asked to design and fabricate gloves to the same set of NASA provided hand measurements (which corresponded to a single size of Phase Vi glove) and focus their efforts on improving mobility in the metacarpal phalangeal and carpometacarpal joints. Four test subjects representing the design-to hand anthropometry completed range of motion, grip/pinch strength, dexterity, and fit evaluations for each glove design in pressurized conditions, with and without thermal micrometeoroid garments (TMG) installed. This paper provides a detailed description of hardware and test methodologies used and lessons learned.

Standardized quantitative measurements of wrist cartilage in healthy humans using 3T magnetic resonance imaging

PubMed Central

Zink, Jean-Vincent; Souteyrand, Philippe; Guis, Sandrine; Chagnaud, Christophe; Fur, Yann Le; Militianu, Daniela; Mattei, Jean-Pierre; Rozenbaum, Michael; Rosner, Itzhak; Guye, Maxime; Bernard, Monique; Bendahan, David

2015-01-01

AIM: To quantify the wrist cartilage cross-sectional area in humans from a 3D magnetic resonance imaging (MRI) dataset and to assess the corresponding reproducibility. METHODS: The study was conducted in 14 healthy volunteers (6 females and 8 males) between 30 and 58 years old and devoid of articular pain. Subjects were asked to lie down in the supine position with the right hand positioned above the pelvic region on top of a home-built rigid platform attached to the scanner bed. The wrist was wrapped with a flexible surface coil. MRI investigations were performed at 3T (Verio-Siemens) using volume interpolated breath hold examination (VIBE) and dual echo steady state (DESS) MRI sequences. Cartilage cross sectional area (CSA) was measured on a slice of interest selected from a 3D dataset of the entire carpus and metacarpal-phalangeal areas on the basis of anatomical criteria using conventional image processing radiology software. Cartilage cross-sectional areas between opposite bones in the carpal region were manually selected and quantified using a thresholding method. RESULTS: Cartilage CSA measurements performed on a selected predefined slice were 292.4 ± 39 mm2 using the VIBE sequence and slightly lower, 270.4 ± 50.6 mm2, with the DESS sequence. The inter (14.1%) and intra (2.4%) subject variability was similar for both MRI methods. The coefficients of variation computed for the repeated measurements were also comparable for the VIBE (2.4%) and the DESS (4.8%) sequences. The carpus length averaged over the group was 37.5 ± 2.8 mm with a 7.45% between-subjects coefficient of variation. Of note, wrist cartilage CSA measured with either the VIBE or the DESS sequences was linearly related to the carpal bone length. The variability between subjects was significantly reduced to 8.4% when the CSA was normalized with respect to the carpal bone length. CONCLUSION: The ratio between wrist cartilage CSA and carpal bone length is a highly reproducible standardized measurement which normalizes the natural diversity between individuals. PMID:26396941

Changes in collagen fibril network organization and proteoglycan distribution in equine articular cartilage during maturation and growth

PubMed Central

Hyttinen, Mika M; Holopainen, Jaakko; René van Weeren, P; Firth, Elwyn C; Helminen, Heikki J; Brama, Pieter A J

2009-01-01

The aim of this study was to record growth-related changes in collagen network organization and proteoglycan distribution in intermittently peak-loaded and continuously lower-level-loaded articular cartilage. Cartilage from the proximal phalangeal bone of the equine metacarpophalangeal joint at birth, at 5, 11 and 18 months, and at 6–10 years of age was collected from two sites. Site 1, at the joint margin, is unloaded at slow gaits but is subjected to high-intensity loading during athletic activity; site 2 is a continuously but less intensively loaded site in the centre of the joint. The degree of collagen parallelism was determined with quantitative polarized light microscopy and the parallelism index for collagen fibrils was computed from the cartilage surface to the osteochondral junction. Concurrent changes in the proteoglycan distribution were quantified with digital densitometry. We found that the parallelism index increased significantly with age (up to 90%). At birth, site 2 exhibited a more organized collagen network than site 1. In adult horses this situation was reversed. The superficial and intermediate zones exhibited the greatest reorganization of collagen. Site 1 had a higher proteoglycan content than site 2 at birth but here too the situation was reversed in adult horses. We conclude that large changes in joint loading during growth and maturation in the period from birth to adulthood profoundly affect the architecture of the collagen network in equine cartilage. In addition, the distribution and content of proteoglycans are modified significantly by altered joint use. Intermittent peak-loading with shear seems to induce higher collagen parallelism and a lower proteoglycan content in cartilage than more constant weight-bearing. Therefore, we hypothesize that the formation of mature articular cartilage with a highly parallel collagen network and relatively low proteoglycan content in the peak-loaded area of a joint is needed to withstand intermittent stress and shear, whereas a constantly weight-bearing joint area benefits from lower collagen parallelism and a higher proteoglycan content. PMID:19732210

Quantitative assessment of early biomechanical modifications in diabetic foot patients: the role of foot kinematics and step width.

PubMed

Lamola, Giuseppe; Venturi, Martina; Martelli, Dario; Iacopi, Elisabetta; Fanciullacci, Chiara; Coppelli, Alberto; Rossi, Bruno; Piaggesi, Alberto; Chisari, Carmelo

2015-11-09

Forefoot ulcers (FU) are one of the most disabling and relevant chronic complications of diabetes mellitus (DM). In recent years there is emerging awareness that a better understanding of the biomechanical factors underlying the diabetic ulcer could lead to improve the management of the disease, with significant socio-economic impacts. Our purpose was to try to detect early biomechanical factors associated with disease progression. Thirty subjects (M/F: 22/8; mean age ± SD: 61,84 ± 10 years) with diagnosis of type II DM were included. The participants were divided into 3 groups (10 subjects per group) according to the stage of evolution of the disease: Group 1, subjects with newly diagnosed type II DM, without clinical or instrumental diabetic peripheral neuropathy (DPN) nor FU (group called "DM"); Group 2, with DPN but without FU (group called "DPN"); Group 3, with DPN and FU (group called "DNU"). All subjects underwent 3-D Gait Analysis during walking at self-selected speed, measuring spatio-temporal, kinematic and kinetic parameters and focusing on ankle and foot joints. The comparative analysis of values between groups was performed using 1-way ANOVA. We also investigated group to group differences with Tukey HSD test. The results taken into consideration were those with a significance of P < 0,05. 95 % confidence interval was also calculated. A progressive and significant trend of reduction of ROM in flexion-extension of the metatarso-phalangeal joint (P = 0.0038) and increasing of step width (P = 0.0265) with the advance of the disease was evident, with a statistically significant difference comparing subjects with recently diagnosed diabetes mellitus and subjects with diabetic neuropathy and foot ulcer (P = 0.0048 for ROM and P = 0.0248 for step width at Tukey's test). The results provide evidence that foot segmental kinematics, along with step width, can be proposed as simple and clear indicators of disease progression. This can be the starting point for planning more targeted strategies to prevent the occurrence and the recurrence of a FU in diabetic subjects.

Epidemiology of open fractures in sport: One centre’s 15-year retrospective study

PubMed Central

Wood, Alexander M; Robertson, Greg A J; MacLeod, Kirsty; Porter, Anna; Court-Brown, Charles M

2017-01-01

AIM To describe the epidemiology of sport-related open fractures from one centre’s adult patient population over a 15-year period. METHODS A retrospective review of a prospectively-collected database was performed: The database contained information all sport-related open fractures, sustained from 1995 to 2009 in the Edinburgh, Mid and East Lothian Populations. RESULTS Over the 15-year period, there were 85 fractures recorded in 84 patients. The annual incidence of open sport-related fractures was 0.01 per 1000 population. The mean age at injury was 29.2 years (range 15-67). There were 70 (83%) males and 14 females (17%). The 6 most common sports were soccer (n = 19, 22%), rugby (n = 9, 11%), cycling (n = 8, 9%), hockey (n = 8, 9%); horse riding (n = 6, 7%) and skiing (n = 6, 7%). The five most common anatomical locations were finger phalanges (n = 30, 35%); tibial diaphysis (n = 19, 23%); forearm (n = 12, 14%); ankle (n = 7, 8%) and metacarpals (n = 5, 6%). The mean injury severity score was 7.02. According to the Gustilo-Anderson classification system, 45 (53%) fractures were grade 1; 28 (33%) fractures were grade 2; 8 (9%) fractures were grade 3a; and 4 (5%) fractures were grade 3b. Out of the total number of fractures, 7 (8%) required plastic surgical intervention as part of management. The types of flaps used were split skin graft (n = 4), fasciocutaneous flaps (n = 2); and adipofascial flap (n = 1). CONCLUSION We analysed the epidemiology of open fractures secondary to sport in one centre over a 15-year period. Soccer and rugby were the most common causative sports while fractures of the finger phalanx and of the tibial diaphysis were the most common sites. Open fractures are uncommon in sport; however, when they are sustained they usually occur on muddy sport fields or forest tracks and therefore must be treated appropriately. It is important that clinicians and sports therapists have knowledge of these injuries, in order to ensure they are managed optimally. PMID:28808625

Application of BCI systems in neurorehabilitation: a scoping review.

PubMed

Bamdad, Mahdi; Zarshenas, Homayoon; Auais, Mohammad A

2015-01-01

To review various types of electroencephalographic activities of the brain and present an overview of brain-computer interface (BCI) systems' history and their applications in rehabilitation. A scoping review of published English literature on BCI application in the field of rehabilitation was undertaken. IEEE Xplore, ScienceDirect, Google Scholar and Scopus databases were searched since inception up to August 2012. All experimental studies published in English and discussed complete cycle of the BCI process was included in the review. In total, 90 articles met the inclusion criteria and were reviewed. Various approaches that improve the accuracy and performance of BCI systems were discussed. Based on BCI's clinical application, reviewed articles were categorized into three groups: motion rehabilitation, speech rehabilitation and virtual reality control (VRC). Almost half of the reviewed papers (48%) concentrated on VRC. Speech rehabilitation and motion rehabilitation made up 33% and 19% of the reviewed papers, respectively. Among different types of electroencephalography signals, P300, steady state visual evoked potentials and motor imagery signals were the most common. This review discussed various applications of BCI in rehabilitation and showed how BCI can be used to improve the quality of life for people with neurological disabilities. It will develop and promote new models of communication and finally, will create an accurate, reliable, online communication between human brain and computer and reduces the negative effects of external stimuli on BCI performance. Implications for Rehabilitation The field of brain-computer interfaces (BCI) is rapidly advancing and it is expected to fulfill a critical role in rehabilitation of neurological disorders and in movement restoration in the forthcoming years. In the near future, BCI has notable potential to become a major tool used by people with disabilities to control locomotion and communicate with surrounding environment and, consequently, improve the quality of life for many affected persons. Electrical field recording at the scalp (i.e. electroencephalography) is the most likely method to be of practical value for clinical use as it is simple and non-invasive. However, some aspects need future improvements, such as the ability to separate close imagery signal (motion of extremities and phalanges that are close together).

The toothless pterosaur Jidapterus edentus (Pterodactyloidea: Azhdarchoidea) from the Early Cretaceous Jehol Biota and its paleoecological implications

PubMed Central

Wu, Wen-Hao; Zhou, Chang-Fu; Andres, Brian

2017-01-01

Background In the Early Cretaceous Jehol Biota, the toothless pterosaurs flourished with the chaoyangopterids and tapejarids playing a key role in understanding the early diversity and evolution of the Azhdarchoidea. Unlike the more diverse tapejarids, the rarer chaoyangopterids are characterized by a long and low rostrum, supporting a close relationship with the huge azhdarchids. Unfortunately, our knowledge is still limited in the osteology, paleoecology, and taxonomy of the Chaoyangopteridae. As one of the best preserved skeletons, the type and only specimen of Jidapterus edentus provides an opportunity to understand the morphology and paleoecology of the chaoyangopterids. Results Our study of the osteology of Jidapterus edentus reveals valuable information about the morphology of the Chaoyangopteridae such as a rostrum with a curved dorsal profile, high Rostral Index (RI), larger angle between the dorsal and postorbital processes of the jugal, sequentially shorter fourth to seventh cervical vertebrae, sternum with a plate wider than long, contact of the metacarpal I with the distal syncarpal, pneumatic foramen on first wing phalanx, hatchet-like postacetabular process with unconstricted neck and small dorsal process, distinctly concave anterior margin of pubis, subrectangular pubic plate with nearly parallel anterior and posterior margins, longer proximal phalanges of pedal digits III and IV, as well as reduced and less curved pedal unguals. These features further support the validity of Jidapterus edentus as a distinct species and the close relationship of the chaoyangopterids with the azhdarchids. Paleoecologically, the chaoyangopterids are probably like the azhdarchids, more terrestrial than the contemporaneous and putatively arboreal tapejarids, which may have been limited to the forest-dominated ecosystem of the Jehol Biota. Discussion The osteology of Jidapterus edentus further supports the close relationship of the Chaoyangopteridae with the Azhdarchidae in sharing a high RI value and reduced and mildly-curved pedal unguals, and it also implies a possible paleoecological similarity in their terrestrial capability. Combined with the putatively arboreal and herbivorous tapejarids, this distinct lifestyle of the chaoyangopterids provides new insights into the diversity of pterosaurs in the ecosystem of the Jehol Biota. PMID:28950013

A cross-sectional observational study comparing foot and ankle characteristics in people with stroke and healthy controls.

PubMed

Kunkel, Dorit; Potter, Julia; Mamode, Louis

2017-06-01

The purpose of this study was to explore and compare foot and ankle characteristics in people with stroke and healthy controls; and between stroke fallers and non-fallers. Participants were recruited from community groups and completed standardized tests assessing sensation, foot posture, foot function, ankle dorsiflexion and first metatarsal phalangeal joint range of motion (1st MPJ ROM), hallux valgus presence and severity. Twenty-three stroke participants (mean age 75.09 ± 7.57 years; 12 fallers) and 16 controls (mean age 73.44 ± 8.35 years) took part. Within the stroke group, reduced 1st MPJ sensation (p = 0.016) and 1st MPJ ROM (p = 0.025) were observed in the affected foot in comparison to the non-affected foot; no other differences were apparent. Pooled data (for both feet) was used to explore between stroke/control (n = 78 feet) and stroke faller/non-faller (n = 46 feet) group differences. In comparison to the control group, stroke participants exhibited reduced sensation of the 1st MPJ (p = 0.020), higher Foot Posture Index scores (indicating greater foot pronation, p = 0.008) and reduced foot function (p = 0.003). Stroke fallers exhibited significantly greater foot pronation in comparison to non-fallers (p = 0.027). Results indicated differences in foot and ankle characteristics post stroke in comparison to healthy controls. These changes may negatively impact functional ability and the ability to preserve balance. Further research is warranted to explore the influence of foot problems on balance ability and falls in people with stroke. Implications for Rehabilitation Foot problems are common post stroke. As foot problems have been linked to increased fall risk among the general population we recommend that it would be beneficial to include foot and ankle assessments or a referral to a podiatrist for people with stroke who report foot problems. Further research is needed to explore if we can improve functional performance post stroke and reduce fall risk if treatment or prevention of foot problems can be included in stroke rehabilitation.

Perceived pitch of vibrotactile stimuli: effects of vibration amplitude, and implications for vibration frequency coding.

PubMed

Morley, J W; Rowe, M J

1990-12-01

1. The effect of changes in amplitude on the perceived pitch of cutaneous vibratory stimuli was studied in psychophysical experiments designed to test whether the coding of information about the frequency of the vibration might be based on the ratio of recruitment of the PC (Pacinian corpuscle-associated) and RA (rapidly adapting) classes of tactile sensory fibres. The study was based on previous data which show that at certain vibration frequencies (e.g. 150 Hz) the ratio of recruitment of the PC and RA classes should vary as a function of vibration amplitude. 2. Sinusoidal vibration at either 30 Hz or 150 Hz, and at an amplitude 10 dB above subjective detection thresholds was delivered in a 1 s train to the distal phalangeal pad of the index finger in eight human subjects. This standard vibration was followed after 0.5 s by a 1 s comparison train of vibration which (unknown to the subject) was at the same frequency as the standard but at a range of amplitudes from 2 to 50 dB above the detection threshold. A two-alternative forced-choice procedure was used in which the subject had to indicate whether the comparison stimulus was higher or lower in pitch (frequency) than the standard. 3. Marked differences were seen from subject to subject in the effect of amplitude on perceived pitch at both 30 Hz and 150 Hz. At 150 Hz, five out of the eight subjects reported an increase in pitch as the amplitude of the comparison vibration increased, one experienced no change, and only two experienced the fall in perceived pitch that is predicted if the proposed ratio code contributes to vibrotactile pitch judgements. At 30 Hz similar intersubject variability was seen in the pitch-amplitude functions. 4. The results do not support the hypothesis that a ratio code contributes to vibrotactile pitch perception. We conclude that temporal patterning of impulse activity remains the major candidate code for pitch perception, at least over a substantial part of the vibrotactile frequency bandwidth.

7D.09: REDUCED VIT D AND ELEVATED URICEMIA INDUCE CAPILLARY RAREFACTION BEFORE MACROVASCULAR DAMAGE IN PATIENTS WITH METABOLIC SYNDROME AT THE VERY EARLY STAGES OF HYPERTENSION.

PubMed

Nazzaro, P; Schirosi, G; De Benedittis, L; Mezzapesa, D; Federico, F

2015-06-01

Reduced (L) Vit D (D) and high (H) uric acid (U) levels have been associate with increased cardiovascular risk. Aim of the study was to highlight their association with the subclinical vascular damage in untreated recently diagnosed very mild hypertensives with a similar number of metabolic syndrome factors (nATPIII). By medical visit and identification of the metabolic syndrome factors, 238 very mild hypertensives (136 ± 15/84 ± 9 mmHg), 62 controls with normal (N) D and U, 96 with LD, 40 with HU and 40 with both the conditions (LDHU) with similar metabolic assessment, underwent measures of carotid-femoral pulse wave velocity (PWV), ankle-brachial index (ABI), carotid intima-media thickness (IMT), as indices of functional and structural arterial damage, and videocapillaroscopy of the middle and distal phalangeal skin of the 2nd, 3rd and 4th finger of the non-dominant hand during baseline (CAP) and venous congestion (CVC) obtaining capillary recruitment (REC) as indices of functional and structural microcirculatory damage. Patients showed a similar hypertensive state during the medical visit and ABPM but different capillary indices.(m ± s:d.*:p<.05, **:p < .01, ***:p < .001 vs NDNU; °:p < .05, °°:p < .01, °°°:p < .001 vs LDNU;^p < .05, ^^:p < .01, ^^^:p < .001 vs NDHU).(Figure is included in full-text article.)Pearson analysis showed the association between Vit D and CVC (.440*) and REC (.335***) in LDNU and with CVC (631***) and REC (.666*) in LDHU as well as between U and CAP (-.470*) in NDHU and (-606*) in LDHU. The results suggest that, in very mild hypertensives with metabolic syndrome, reduced Vit D is associate to structural microvascular damage before the onset of structural or functional macrovascular impairment. Hyperuricemia show a lower microcirculatory damage but this is amplified in patients with both the disorders (LDHU).

Benchmarking Evaluation Results for Prototype Extravehicular Activity Gloves

NASA Technical Reports Server (NTRS)

Aitchison, Lindsay; McFarland, Shane

2012-01-01

The Space Suit Assembly (SSA) Development Team at NASA Johnson Space Center has invested heavily in the advancement of rear-entry planetary exploration suit design but largely deferred development of extravehicular activity (EVA) glove designs, and accepted the risk of using the current flight gloves, Phase VI, for unique mission scenarios outside the Space Shuttle and International Space Station (ISS) Program realm of experience. However, as design reference missions mature, the risks of using heritage hardware have highlighted the need for developing robust new glove technologies. To address the technology gap, the NASA Game-Changing Technology group provided start-up funding for the High Performance EVA Glove (HPEG) Project in the spring of 2012. The overarching goal of the HPEG Project is to develop a robust glove design that increases human performance during EVA and creates pathway for future implementation of emergent technologies, with specific aims of increasing pressurized mobility to 60% of barehanded capability, increasing the durability by 100%, and decreasing the potential of gloves to cause injury during use. The HPEG Project focused initial efforts on identifying potential new technologies and benchmarking the performance of current state of the art gloves to identify trends in design and fit leading to establish standards and metrics against which emerging technologies can be assessed at both the component and assembly levels. The first of the benchmarking tests evaluated the quantitative mobility performance and subjective fit of four prototype gloves developed by Flagsuit LLC, Final Frontier Designs, LLC Dover, and David Clark Company as compared to the Phase VI. All of the companies were asked to design and fabricate gloves to the same set of NASA provided hand measurements (which corresponded to a single size of Phase Vi glove) and focus their efforts on improving mobility in the metacarpal phalangeal and carpometacarpal joints. Four test subjects representing the design ]to hand anthropometry completed range of motion, grip/pinch strength, dexterity, and fit evaluations for each glove design in both the unpressurized and pressurized conditions. This paper provides a comparison of the test results along with a detailed description of hardware and test methodologies used.

Anthropometric changes in elite male water polo players: survey in 1980 and 1995.

PubMed

Lozovina, Vinko; Pavicić, Leo

2004-04-01

To assess the differences in anthropometric parameters, body fat, body mass index (BMI), and body density induced by sport-specific morphological optimization (adaptation) between two generations (1980 and 1995) of male elite water polo players. The survey included a total of 160 elite male water polo players, all members of the top clubs in Croatia. The 1980's generation consisted of 95 players (71.9% of target population) aged between 18 and 32 years, and the 1995's generation included 65 players (50% of target population) aged between 19 and 29 years. Trained and qualified anthropometrists performed the measurements under standardized experimental conditions and in accordance with the procedures described by the International Biological Program. They measured 23 anthropometric variables reflecting basic human body characteristics described by skeletal bone lengths (total leg length, total arm length, hand length, foot length, and height), breadths (hand at proximal phalanges, foot in metatarsal area, biacromial, biiliocristal, biepycondylar femur, biepycondyar humerus, and radio-ulnar wrist breadth), girths (chest, arm, forearm, thigh, and calf girth), skinfold thickness as a measure of subcutaneous adiposity (triceps, subscapular, axillary, calf, and abdominal skinfold thickness), and mass. Additionally, estimates of body mass index (BMI), body density, and percentage of body fat were calculated from the primary measures. Comparison between anthropometric measures of the two generations of water polo players revealed a positive trend in body skeletal measures and negative trend in body adiposity measures. Most noteworthy differences (d) were an increase in height (d=37.3 mm, p

Sports Injury-Related Fingers and Thumb Deformity Due to Tendon or Ligament Rupture.

PubMed

Bai, Rong-Jie; Zhang, Hui-Bo; Zhan, Hui-Li; Qian, Zhan-Hua; Wang, Nai-Li; Liu, Yue; Li, Wen-Ting; Yin, Yu-Ming

2018-05-05

Hand injuries are very common in sports, such as skiing and ball sports. One of the major reasons causing hand and finger deformity is due to ligament and tendon injury. The aim of this study was to investigate if the high-resolution 3T magnetic resonance imaging (MRI) can demonstrate the complex anatomy of the fingers and thumb, especially the tendons and ligaments, and provide the accurate diagnosis of clinically important fingers and thumbs deformity due to ligamentous and tendinous injuries during sport activities. Sixteen fresh un-embalmed cadaveric hands were harvested from eight cadavers. A total of 20 healthy volunteers' hands and 44 patients with fingers or thumb deformity due to sports-related injuries were included in this study. All subjects had MR examination with T1-weighted images and proton density-weighted imaging with fat suppression (PD FS) in axial, coronal, and sagittal plane, respectively. Subsequently, all 16 cadaveric hands were sliced into 2-mm thick slab with a band saw (six in coronal plane, six in sagittal plane, and four in axial plane). The correlation of anatomic sections and the MRI characteristics of tendons of fingers and the ulnar collateral ligament (UCL) at the metacarpal phalangeal joint (MCPJ) of thumb between 20 healthy volunteers and 44 patients (confirmed by surgery) were analyzed. The normal ligaments and tendons in 16 cadaveric hands and 20 volunteers' hands showed uniform low-signal intensity on all the sequences of the MRI. Among 44 patients with tendinous and ligamentous injuries in the fingers or thumb, 12 cases with UCL injury at MCPJ of the thumb (Stener lesion = 8 and non-Stener lesion = 4), 6 cases with the central slip injury, 12 cases with terminal tendon injury, and 14 cases with flexor digitorum profundus injury. The ligaments and tendons disruption manifested as increased signal intensity and poor definition, discontinuity, and heterogeneous signal intensity of the involved ligaments and tendons. Sports injury-related fingers and thumb deformity are relatively common. MRI is an accurate method for evaluation of the anatomy and pathologic conditions of the fingers and thumb. It is a useful tool for accurate diagnosis of the sports-related ligaments and tendons injuries in hand.

[Effectiveness of arthroscopic treatment of anterior cruciate ligament tibial eminence avulsion fracture with non-absorbable suture fixation combined with mini-plate].

PubMed

Wang, Suiyuan; Xiao, Yang; Tong, Zuoming; Li, Guiqiu; Jiang, Juhua; Yao, Jinghui; Wu, Zhiyong; Li, Tengfei; Wu, Qun

2013-09-01

To evaluate the surgical techniques and effectiveness of arthroscopic treatment of anterior cruciate ligament (ACL) tibial eminence avulsion fracture with non-absorbable suture fixation combined with the miniplate. Between January 2009 and March 2012, 32 patients with ACL tibial eminence avulsion fractures were treated. There were 18 males and 14 females, aged 12-40 years (mean, 17.5 years). The injury causes included traffic accident injury in 15 cases, sport injury in 6 cases, and falling injury in 11 cases. The time from injury to operation ranged 7-18 days with an average of 9.5 days. Before operation, the results of Lachman test were all positive; the Lysholm score was 52.13 +/- 4.22 and the International Knee Documentation Committee (IKDC) score was 44.82 +/- 2.44. According to Meyers-McKeever classification criteria, there were 12 cases of type II and 20 cases of type III. After arthroscopic poking reduction of fracture, tibial eminence avulsion fractures were fixed with the Ethibond non-absorbable sutures bypass figure-of-eight tibial tunnel combined with the metacarpal and phalangeal mini-plate. Primary healing was obtained in all incisions; no joint infection or skin necrosis occurred after operation. All patients were followed up with an average time of 22.4 months (range, 12-50 months). The patients showed negative Lachman test at 12 weeks after operation. Except 3 patients having knee extension limitation at last follow-up, the knee extension range of motion (ROM) was normal in the other patients; the knee flexion ROM was normal in all patients. The Lysholm score and IKDC score were significantly improved to 94.19 +/- 0.93 and 94.35 +/- 1.22 at last follow-up, showing significant differences when compared with preoperative values (t = 55.080, P = 0.000; t = 101.715, P = 0.000). The arthroscopic treatment of ACL tibial eminence avulsion fracture with Ethibond non-absorbable suture fixation combined with mini-plate is an effective procedure with the advantages of minimal trauma, reliable fixation, and satisfactory recovery of the knee joint function.

[Acroosteolysis in PVC autoclave cleaners: history of an occupational disease].

PubMed

Zocchetti, C; Osculati, A; Colosio, C

2010-01-01

This paper examines the history of an occupational disease which has now disappeared: acroosteolysis of manual tank cleaners in the production of polyvinyl chloride (PVC), which is a rare disease characterized by destructive alterations of the distal phalanges of the hands. All the available literature on this disease was examined. The history of acroosteolysis was studied within the general framework of the history of the discovery of adverse health effects of exposure to vinyl chloride, and this history was studied up to the end of the 1960's. The disease was observed for the first time in mid-1963 in Belgium (Jemeppe) in a chemical plant operated by Solvay, and affected two workers whose job was the manual cleaning of vessels used for the polymerization of vinyl chloride; similar cases occurred in almost all PVC production plants all over the world, but not in the plants where the main activity was the production of vinyl chloride monomer (VCM). Little more than one hundred cases are described in the scientific literature, and this number increases by a few dozen if we consider known but unpublished cases. These figures confirm the rarity of the disease, which peaked at the end of the 1960's and disappeared during the 1970's, probably due to the complete elimination of manual reactor cleaning. Observation of the disease lasted no more than fifteen years and the disease was not replicated in experimental conditions on animals. The disease was clinically characterized, had a short latency (from several months to several years), was rare and unequivocally linked to the manual cleaning of PVC polymerization tanks. However many questions still remain open: the period when the disease first appeared (many years after the start of PVC production in the world), the etiology of the disease (the most accredited hypothesis considers three concomitant factors: a chemical factor--one of the many substances used during polymerization, and particularly vinyl chloride monomer, a physical factor--microtraumas of the fingers during manual cleaning, individual susceptibility), the pathogenetic mechanism (in particular: the role of skin, respiratory, or digestive system, as entrance door), a method (or test) to screen subjects potentially predisposed to the disease. In our view acroosteolysis of manual tank cleaners in PVC production is an occupational disease which is distinct from "vinyl chloride disease" as identified by Viola (1974).

Validation of 2 noninvasive, markerless reconstruction techniques in biplane high-speed fluoroscopy for 3-dimensional research of bovine distal limb kinematics.

PubMed

Weiss, M; Reich, E; Grund, S; Mülling, C K W; Geiger, S M

2017-10-01

Lameness severely impairs cattle's locomotion, and it is among the most important threats to animal welfare, performance, and productivity in the modern dairy industry. However, insight into the pathological alterations of claw biomechanics leading to lameness and an understanding of the biomechanics behind development of claw lesions causing lameness are limited. Biplane high-speed fluoroscopic kinematography is a new approach for the analysis of skeletal motion. Biplane high-speed videos in combination with bone scans can be used for 3-dimensional (3D) animations of bones moving in 3D space. The gold standard, marker-based animation, requires implantation of radio-opaque markers into bones, which impairs the practicability for lameness research in live animals. Therefore, the purpose of this study was to evaluate the comparative accuracy of 2 noninvasive, markerless animation techniques (semi-automatic and manual) in 3D animation of the bovine distal limb. Tantalum markers were implanted into each of the distal, middle, and proximal phalanges of 5 isolated bovine distal forelimbs, and biplane high-speed x-ray videos of each limb were recorded to capture the simulation of one step. The limbs were scanned by computed tomography to create bone models of the 6 digital bones, and 3D animation of the bones' movements were subsequently reconstructed using the marker-based, the semi-automatic, and the manual animation techniques. Manual animation translational bias and precision varied from 0.63 ± 0.26 mm to 0.80 ± 0.49 mm, and rotational bias and precision ranged from 2.41 ± 1.43° to 6.75 ± 4.67°. Semi-automatic translational values for bias and precision ranged from 1.26 ± 1.28 mm to 2.75 ± 2.17 mm, and rotational values varied from 3.81 ± 2.78° to 11.7 ± 8.11°. In our study, we demonstrated the successful application of biplane high-speed fluoroscopic kinematography to gait analysis of bovine distal limb. Using the manual animation technique, kinematics can be measured with sub-millimeter accuracy without the need for invasive marker implantation. Copyright © 2017 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Comparison of the effects of three oral bisphosphonate therapies on the peripheral skeleton in postmenopausal osteoporosis: the TRIO study.

PubMed

Paggiosi, M A; Peel, N; McCloskey, E; Walsh, J S; Eastell, R

2014-12-01

We compared the effects of oral alendronate, ibandronate and risedronate on the central and peripheral skeleton over 2 years. We report differences in effect on the central skeleton but not on the peripheral skeleton. Greater effects were observed for ibandronate (and alendronate) than risedronate at the spine but not the hip. Generally, comparative clinical trials of bisphosphonates have examined changes in bone within central skeletal regions. We have examined the effects of bisphosphonate treatment on the peripheral skeleton. We conducted a 2-year, open-label, parallel randomised control trial of three orally administered bisphosphonates, at their licensed dose, to examine and compare their effects on the peripheral skeleton using multiple modes of measurement. We studied 172 postmenopausal women (53-84 years) who had either a bone mineral density (BMD) T-score of  ≤ -2.5 at the spine and/or total hip or  < -1.0 at either site plus a previous low trauma fracture. Participants were randomised to receive either (i) ibandronate 150 mg/month, (ii) alendronate 70 mg/week or (iii) risedronate 35 mg/week, plus calcium (1,200 mg/day) and vitamin D (800 IU/day), for 2 years. Premenopausal women (33-40 years, n = 226) were studied to monitor device stability. We measured central BMD of the lumbar spine, total hip, total body and forearm using dual-energy X-ray absorptiometry. We measured calcaneus BMD (using dual-energy X-ray absorptiometry plus laser), radius and tibia BMD (using peripheral quantitative computed tomography), finger BMD (using radiographic absorptiometry), and phalangeal and calcaneal ultrasound variables (using quantitative ultrasound). Mixed effects regression models were used to evaluate effects of time and treatment allocation on BMD change. By 2 years, there were significant increases (p < 0.05) in central BMD sites (lumbar spine, total hip). In the peripheral skeleton, only significant changes in calcaneus BMD, 33 % total radius BMD and quantitative ultrasound (QUS)-2 broadband ultrasound attenuation (BUA) were evident for women receiving oral bisphosphonates. The increases in lumbar spine and total body BMD were greater with ibandronate and alendronate than with risedronate. Treatment effects on peripheral measurements did not differ between the three bisphosphonates.

The AL 333-160 fourth metatarsal from Hadar compared to that of humans, great apes, baboons and proboscis monkeys: non-conclusive evidence for pedal arches or obligate bipedality in Hadar hominins.

PubMed

Mitchell, P J; Sarmiento, E E; Meldrum, D J

2012-10-01

Based on comparisons to non-statistically representative samples of humans and two great ape species (i.e. common chimpanzees Pan troglodytes and lowland gorillas Gorilla gorilla), Ward et al. (2011) concluded that a complete hominin fourth metatarsal (4th MT) from Hadar, AL 333-160, belonged to a committed terrestrial biped with fixed transverse and longitudinal pedal arches, which was no longer under selection favoring substantial arboreal behaviors. According to Ward et al., the Hadar 4th MT had (1) a torsion value indicating a transverse arch, (2) sagittal plane angles between the diaphyseal long axis and the planes of the articular surfaces indicating a longitudinal arch, and (3) a narrow mediolateral to dorsoplantar base ratio, an ectocuneiform facet, and tarsal articular surface contours all indicating a rigid foot without an ape-like mid-tarsal break. Comparisons of the Hadar 4th MT characters to those of statistically representative samples of humans, all five great ape species, baboons and proboscis monkeys show that none of the correlations Ward et al. make to localized foot function were supported by this analysis. The Hadar 4th MT characters are common to catarrhines that have a midtarsal break and lack fixed transverse or longitudinal arches. Further comparison of the AL 333-160 4th MT length, and base, midshaft and head circumferences to those of catarrhines with field collected body weights show that this bone is uniquely short with a large base. Its length suggests the AL 333-160 individual was a poor leaper with limited arboreal behaviors and lacked a longitudinal arch, i.e. its 4th MT long axis was usually held perpendicular to gravity. Its large base implies cuboid-4th MT joint mobility. A relatively short 4th MT head circumference indicates AL 333-160 had small proximal phalanges with a restricted range of mobility. Overall, AL 333-160 is most similar to the 4th MT of eastern gorillas, a slow moving quadruped that sacrifices arboreal behaviors for terrestrial ones. This study highlights evolutionary misconceptions underlying the practice of using localized anatomy and/or a single bony element to reconstruct overall locomotor behaviors and of summarizing great ape structure and behavior based on non-statistically representative samples of only a few living great ape species. Copyright © 2012. Published by Elsevier GmbH.

Reactive oxygen species are involved in lipopolysaccharide-induced intrauterine growth restriction and skeletal development retardation in mice.

PubMed

Xu, De-Xiang; Chen, Yuan-Hua; Zhao, Lei; Wang, Hua; Wei, Wei

2006-12-01

Maternal infection is a cause of adverse developmental outcomes including embryonic resorption, intrauterine fetal death, and preterm labor. Lipopolysaccharide-induced developmental toxicity at early gestational stages has been well characterized. The purpose of the present study was to investigate the effects of maternal lipopolysaccharide exposure at late gestational stages on intrauterine fetal growth and skeletal development and to assess the potential role of reactive oxygen species in lipopolysaccharide-induced intrauterine fetal growth restriction and skeletal development retardation. The timed pregnant CD-1 mice were intraperitoneally injected with lipopolysaccharide (25 to 75 microg/kg per day) on gestational day 15 to 17. To investigate the role of reactive oxygen species on lipopolysaccharide-induced intrauterine fetal growth restriction and skeletal development retardation, the pregnant mice were injected with alpha-phenyl-N-t-butylnitrone (100 mg/kg, intraperitoneally) at 30 minutes before lipopolysaccharide (75 microg/kg per day, intraperitoneally), followed by an additional dose of alpha-phenyl-N-t-butylnitrone (50 mg/kg, intraperitoneally) at 3 hours after lipopolysaccharide. The number of live fetuses, dead fetuses, and resorption sites was counted on gestational day 18. Live fetuses in each litter were weighed. Crown-rump and tail lengths were examined and skeletal development was evaluated. Maternal lipopolysaccharide exposure significantly increased fetal mortality, reduced fetal weight and crown-rump and tail lengths of live fetuses, and retarded skeletal ossification in caudal vertebrae, anterior and posterior phalanges, and supraoccipital bone in a dose-dependent manner. Alpha-phenyl-N-t-butylnitrone, a free radical spin-trapping agent, almost completely blocked lipopolysaccharide-induced fetal death (63.2% in lipopolysaccharide group versus 6.5% in alpha-phenyl-N-t-butylnitrone + lipopolysaccharide group, P < .01). In addition, alpha-phenyl-N-t-butylnitrone significantly reversed lipopolysaccharide-induced intrauterine growth restriction and skeletal development retardation. However, aminoguanidine, a selective inhibitor of inducible nitric oxide synthase, had little effect. Furthermore, lipopolysaccharide-induced intrauterine fetal death, intrauterine fetal growth restriction, and skeletal development retardation were associated with lipid peroxidation and glutathione depletion in maternal liver, placenta, and fetal liver. Alpha-phenyl-N-t-butylnitrone significantly attenuated lipopolysaccharide-induced lipid peroxidation and glutathione depletion in maternal liver, placenta, and fetal liver. Maternal lipopolysaccharide exposure at late gestational stages results in intrauterine fetal growth restriction and skeletal development retardation in mice. Reactive oxygen species might be, at least in part, involved in lipopolysaccharide-induced intrauterine fetal growth restriction and skeletal development retardation.

[Long-term effects of 7-year growth hormone substitution on bone metabolism, bone density, and bone quality in growth hormone-deficient adults].

PubMed

Wilhelm, Birgit; Kann, Peter Herbert

2004-10-15

Subnormal bone mineral density (BMD) and increased fracture risk are described in patients with growth hormone deficiency (GHD). Growth hormone (GH) has been reported to have beneficial effects on bone in GHD. The aim of this study was to investigate the long-term effects of GH replacement therapy on bone metabolism, BMD, and bone quality in patients with GHD. 20 adult patients with GHD (eleven male, nine female, mean age 42.5 years) were included in the study and randomized to either GH or placebo in a dose of 0.25 U/kg body weight/week. After 6 months all patients received GH. After a 1-year double-blind, placebo-controlled study the patients were followed for another 72 months in an open study. The patients were compared to 20 age- und sex-matched healthy controls. Bone turnover was determined by ICTP (type I collagen carboxyterminal cross-linked telopeptide) as parameter of bone resorption and PICP (carboxyterminal propeptide of type I procollagen) as marker of bone formation. BMD was measured at the lumbar spine by dual-photon absorptiometry (DPA) and at the forearm by single-photon absorptiometry (SPA). Apparent phalangeal ultrasound transmission velocity (APU) was assessed as parameter of bone quality independent of BMD. At the beginning of the study BMD at both measuring sites was lower in patients with GHD than in healthy controls. During the 1st year of GH replacement therapy BMD decreased, followed by a continuous increase in BMD (about 12%) up to 60 months which remained unchanged thereafter, building up a plateau. After 72 months no significant difference between the patients and the healthy controls could be detected. Concerning parameters of bone turnover, first ICTP as marker of bone resorption showed a significant increase, later on the marker of bone formation increased as well. APU decreased during the first 6 months of treatment, but had returned to its baseline value after 24 months and remained unchanged throughout the rest of the study. BMD is subnormal in adults with GHD. GH replacement therapy stimulates bone turnover in patients with GHD and in the long term such stimulation results in an increased BMD. Thereby, GH shows a triphasic action on BMD: an initial decrease in BMD during the 1st year, followed by a continuous increase in BMD with buildup of a stable plateau after 60 months. The newly formed bone seems to have normal bone elasticity.

Discriminatory ability of quantitative ultrasound parameters and bone mineral density in a population-based sample of postmenopausal women with vertebral fractures: results of the Basel Osteoporosis Study.

PubMed

Hartl, F; Tyndall, A; Kraenzlin, M; Bachmeier, C; Gückel, C; Senn, U; Hans, D; Theiler, R

2002-02-01

The discriminatory potential to classify subjects with or without vertebral fractures was tested cross-sectionally with different methods for the measurement of bone status in a population-based sample of postmenopausal women. Quantitative ultrasound (QUS) measurement at the calcaneus (Lunar Achilles, Hologic Sahara), the proximal phalanges (Igea Bone Profiler), and measurement of bone mineral density (BMD) with dual-energy X-ray absorptiometry (DXA; Lunar Expert) at several anatomic sites was performed in 500 postmenopausal women (aged 65-75 years) randomly selected from the population. In addition, 50 young female subjects (20-40 years old) had QUS measurements and served as controls to express QUS results as T-score values. Radiographs of the lumbar and thoracic spine were performed in the elderly women. Two independent radiologists reviewed the X-rays for the presence of vertebral fractures. Of 486 eligible study participants, no fracture was seen in 396 participants. Single vertebral fractures were observed in 71 subjects; 19 individuals presented multiple fractures. The overall prevalence of vertebral fractures was 18.5%. Participants without vertebral fractures were compared with subjects with vertebral fractures. Normal statistical distributions were found for all bone measurement results. Risk of vertebral fracture in subjects with no and multiple vertebral fracture was estimated using age adjusted odds ratios (ORs) for QUS and dual-energy X-ray absorptiometry (DXA) values. Each SD decrease in bone measurement increased the risk of multiple vertebral fracture by 3.0 (95% CI, 1.6-5.6) for the Achilles stiffness, by 3.8 (95% CI, 1.8-8.2) for the Sahara QUI, 2.1 (95% CI, 1.3-3.4) for the Bone Profiler amplitude-dependent speed of sound (AD-SOS), and 2.1 (95% CI, 1.2-3.9) and 2.4 (95% CI, 1.3-4.3) for DXA lumbar spine and for DXA total hip, respectively. Results of a discriminant analysis showed sensitivities between 84% and 58% and specificities between 72% and 58% for the respective DXA and QUS parameters. Optimum fracture thresholds for QUS measurements derived from this analysis were calculated also. Optimum T-score threshold values for QUS measurements tended to be higher than those for DXA measurements. However, the performance of QUS measurements is at least comparable with DXA measurements in identifying subjects with multiple vertebral fractures randomly selected from the population.

Fragile X checklists: A meta-analysis and development of a simplified universal clinical checklist.

PubMed

Lubala, Toni Kasole; Lumaka, Aimé; Kanteng, Gray; Mutesa, Léon; Mukuku, Olivier; Wembonyama, Stanislas; Hagerman, Randi; Luboya, Oscar Numbi; Lukusa Tshilobo, Prosper

2018-04-06

Clinical checklists available have been developed to assess the risk of a positive Fragile X syndrome but they include relatively small sample sizes. Therefore, we carried out a meta-analysis that included statistical pooling of study results to obtain accurate figures on the prevalence of clinical predictors of Fragile X syndrome among patients with intellectual disability, thereby helping health professionals to improve their referrals for Fragile X testing. All published studies consisting of cytogenetic and/or molecular screening for fragile X syndrome among patients with intellectual disability, were eligible for the meta-analysis. All patients enrolled in clinical checklists trials of Fragile X syndrome were eligible for this review, with no exclusion based on ethnicity or age. Odds ratio values, with 95% confidence intervals as well as Cronbach coefficient alpha, was reported to assess the frequency of clinical characteristics in subjects with intellectual disability with and without the fragile X mutation to determine the most discriminating. The following features were strongly associated with Fragile X syndrome: skin soft and velvety on the palms with redundancy of skin on the dorsum of hand [OR: 16.85 (95% CI 10.4-27.3; α:0.97)], large testes [OR: 7.14 (95% CI 5.53-9.22; α: 0.80)], large and prominent ears [OR: 18.62 (95% CI 14.38-24.1; α: 0.98)], pale blue eyes [OR: 8.97 (95% CI 4.75-16.97; α: 0.83)], family history of intellectual disability [OR: 3.43 (95% CI 2.76-4.27; α: 0.81)] as well as autistic-like behavior [OR: 3.08 (95% CI 2.48-3.83; α: 0.77)], Flat feet [OR: 11.53 (95% CI 6.79-19.56; α:0.91)], plantar crease [OR: 3.74 (95% CI 2.67-5.24; α: 0.70)]. We noted a weaker positive association between transverse palmar crease [OR: 2.68 (95% CI 1.70-4.18; α: 0.51)], elongated face [OR: 3.69 (95% CI 2.84-4.81; α: 0.63)]; hyperextensible metacarpo-phalangeal joints [OR: 2.68 (95% CI 2.15-3.34; α: 0.57)] and the Fragile X syndrome. This study has identified the highest risk features for patients with Fragile X syndrome that have been used to design a universal clinical checklist. © 2018 The Authors. Molecular Genetics & Genomic Medicine published by Wiley Periodicals, Inc.

The Venice specimen of Ouranosaurus nigeriensis (Dinosauria, Ornithopoda).

PubMed

Bertozzo, Filippo; Dalla Vecchia, Fabio Marco; Fabbri, Matteo

2017-01-01

Ouranosaurus nigeriensis is an iconic African dinosaur taxon that has been described on the basis of two nearly complete skeletons from the Lower Cretaceous Gadoufaoua locality of the Ténéré desert in Niger. The entire holotype and a few bones attributed to the paratype formed the basis of the original description by Taquet (1976). A mounted skeleton that appears to correspond to O. nigeriensis has been on public display since 1975, exhibited at the Natural History Museum of Venice. It was never explicitly reported whether the Venice specimen represents a paratype and therefore, the second nearly complete skeleton reported in literature or a third unreported skeleton. The purpose of this paper is to disentangle the complex history of the various skeletal remains that have been attributed to Ouranosaurus nigeriensis (aided by an unpublished field map of the paratype) and to describe in detail the osteology of the Venice skeleton. The latter includes the paratype material (found in 1970 and collected in 1972), with the exception of the left femur, the right coracoid and one manus ungual phalanx I, which were replaced with plaster copies, and (possibly) other manus phalanges. Some other elements (e.g., the first two chevrons, the right femur, the right tibia, two dorsal vertebrae and some pelvic bones) were likely added from other individual/s. The vertebral column of the paratype was articulated and provides a better reference for the vertebral count of this taxon than the holotype. Several anatomical differences are observed between the holotype and the Venice specimen. Most of them can be ascribed to intraspecific variability (individual or ontogenetic), but some are probably caused by mistakes in the preparation or assemblage of the skeletal elements in both specimens. The body length of the Venice skeleton is about 90% the linear size of the holotype. Osteohistological analysis (the first for this taxon) of some long bones, a rib and a dorsal neural spine reveals that the Venice specimen is a sub-adult; this conclusion is supported by somatic evidence of immaturity. The dorsal 'sail' formed by the elongated neural spines of the dorsal, sacral and proximal caudal vertebrae characterizes this taxon among ornithopods; a display role is considered to be the most probable function for this bizarre structure. Compared to the mid-1970s, new information from the Venice specimen and many iguanodontian taxa known today allowed for an improved diagnosis of O. nigeriensis.

The Venice specimen of Ouranosaurus nigeriensis (Dinosauria, Ornithopoda)

PubMed Central

2017-01-01

Ouranosaurus nigeriensis is an iconic African dinosaur taxon that has been described on the basis of two nearly complete skeletons from the Lower Cretaceous Gadoufaoua locality of the Ténéré desert in Niger. The entire holotype and a few bones attributed to the paratype formed the basis of the original description by Taquet (1976). A mounted skeleton that appears to correspond to O. nigeriensis has been on public display since 1975, exhibited at the Natural History Museum of Venice. It was never explicitly reported whether the Venice specimen represents a paratype and therefore, the second nearly complete skeleton reported in literature or a third unreported skeleton. The purpose of this paper is to disentangle the complex history of the various skeletal remains that have been attributed to Ouranosaurus nigeriensis (aided by an unpublished field map of the paratype) and to describe in detail the osteology of the Venice skeleton. The latter includes the paratype material (found in 1970 and collected in 1972), with the exception of the left femur, the right coracoid and one manus ungual phalanx I, which were replaced with plaster copies, and (possibly) other manus phalanges. Some other elements (e.g., the first two chevrons, the right femur, the right tibia, two dorsal vertebrae and some pelvic bones) were likely added from other individual/s. The vertebral column of the paratype was articulated and provides a better reference for the vertebral count of this taxon than the holotype. Several anatomical differences are observed between the holotype and the Venice specimen. Most of them can be ascribed to intraspecific variability (individual or ontogenetic), but some are probably caused by mistakes in the preparation or assemblage of the skeletal elements in both specimens. The body length of the Venice skeleton is about 90% the linear size of the holotype. Osteohistological analysis (the first for this taxon) of some long bones, a rib and a dorsal neural spine reveals that the Venice specimen is a sub-adult; this conclusion is supported by somatic evidence of immaturity. The dorsal ‘sail’ formed by the elongated neural spines of the dorsal, sacral and proximal caudal vertebrae characterizes this taxon among ornithopods; a display role is considered to be the most probable function for this bizarre structure. Compared to the mid-1970s, new information from the Venice specimen and many iguanodontian taxa known today allowed for an improved diagnosis of O. nigeriensis. PMID:28649466

The influence of a small insert, in the footbed of a shoe, upon plantar pressure distribution.

PubMed

Burgess, S; Jordan, C; Bartlett, RM

1997-04-01

INTRODUCTION:: A recent development in plantar pressure distribution research, has been the study of the effects of sensory input on pressure distribution. It has been suggested that proprioceptive and exteroceptive information received from the plantar surface of the foot plays an important role in adapting to high pressures in shoes. Robbins and Gouw (1991) suggested that surface irregularities should be added to the insoles of running shoes to gain correct sensory input. Hayda et al. (1994) found that placing a pad proximal to the metatarsal heads produced significant reductions in forefoot plantar pressures around the first and second metatarsal heads. A development by Villeneuve (1993), 'La Posteropodle', utilized a small insert to maintain postural equilibrium, by stimulating the mechanoreceptors in the plantar surface of the foot. The aim of this study was to measure changes in plantar pressure distribution using a small circular insert. METHODS:: Ten non-pathological male subjects were tested whilst walking, after one day of wearing a pair of oxfords (hard) and running shoes (soft), containing an insert of 4 mm in height placed on a 0.8 mm EVA insole. The foot was split into five sections: (1) midfoot, (2) first metatarsal head, (3) 2nd and 3rd metatarsal heads, (4) 4th and 5th metatarsal heads, (5) the phalanges. A PEDAR system (Novel GmbH) was used to collect in-shoe plantar pressure data, with data collections at the beginning and end of a working day. Subjects were tested under two conditions: (1) the insert 5 mm proximal to the metatarsal heads, between the 2nd and 3rd heads, (2) a control, with no insert. RESULTS:: Preliminary results indicate that whilst wearing a hard shoe the insert had the effect of shifting peak pressures from the first metatarsal head, to the area of the second and third metatarsal heads. Peak pressures were found to be lower with the insert present. This has not yet been tested for significance. With the running shoe there appeared to be no significant differences between conditions with and without the insert. There were also no differences between the beginning and end of the day, for both shoe types. DISCUSSION:: From the results it appears that the insert is successful in both shifting peak pressures from the medial to the lateral forefoot, whilst reducing peak pressures simultaneously. This was only evident in the hard shoe condition however, suggesting that the footbed of the running shoe was perhaps too soft to allow the insert to influence sensory input sufficiently. These findings indicate that there may be implications for the use of small orthotics. Further study is required, however, to fully substantiate this hypothesis.

Correlation between extension-block K-wire insertion angle and postoperative extension loss in mallet finger fracture.

PubMed

Lee, S K; Kim, Y H; Moon, K H; Choy, W S

2018-02-01

Extension-block pinning represents a simple and reliable surgical technique. Although this procedure is commonly performed successfully, some patients develop postoperative extension loss. To date, the relationship between extension-block Kirschner wire (K-wire) insertion angle and postoperative extension loss in mallet finger fracture remains unclear. We aimed to clarify this relationship and further evaluate how various operative and non-operative factors affect postoperative extension loss after extension-block pinning for mallet finger fracture. A retrospective study was conducted to investigate a relationship between extension block K-wire insertion angle and postoperative extension loss. The inclusion criteria were: (1) a dorsal intra-articular fracture fragment involving 30% of the base of the distal phalanx with or without volar subluxation of the distal phalanx; and (2) <3 weeks delay from the injury without treatment. Extension-block K-wire insertion angle and fixation angle of the distal interphalangeal (DIP) joint were assessed using lateral radiograph at immediate postoperative time. Postoperative extension loss was assessed by using lateral radiograph at latest follow-up. Extension-block K-wire insertion angle was defined as the acute angle between extension block K-wire and longitudinal axis of middle phalangeal head. DIP joint fixation angle was defined as the acute angle between the distal phalanx and middle phalanx longitudinal axes. Seventy-five patients were included. The correlation analysis revealed that extension-block K-wire insertion angle had a negative correlation with postoperative extension loss, whereas fracture size and time to operation had a positive correlation (correlation coefficient for extension block K-wire angle: -0.66, facture size: +0.67, time to operation: +0.60). When stratifying patients in terms of negative and positive fixation angle of the DIP joint, the independent t-test showed that mean postoperative extension loss is -3.67° and +4.54° (DIP joint fixation angles of <0° and ≥0°, respectively, P=0.024). When stratifying patients in terms of extension-block K-wire insertion angle (30°, 30°-40°, >40°), ANOVA showed significantly less postoperative extension loss for higher insertion angles (>40°) than for medium insertion angles (30°-40°). Mean postoperative extension loss difference between higher insertion angle (>40°) and medium insertion angle (30°-40°) was 11° (P=0.002). Using an insertion angle of the extension-block K-wire of 40°-45° and a slightly hyperextended position of the DIP joint may help reducing postoperative extension loss. Therapeutic level III. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

A preliminary case study of the effect of shoe-wearing on the biomechanics of a horse’s foot

PubMed Central

Rankin, Jeffery W.; Gatesy, Stephen M.

2016-01-01

Horse racing is a multi-billion-dollar industry that has raised welfare concerns due to injured and euthanized animals. Whilst the cause of musculoskeletal injuries that lead to horse morbidity and mortality is multifactorial, pre-existing pathologies, increased speeds and substrate of the racecourse are likely contributors to foot disease. Horse hooves have the ability to naturally deform during locomotion and dissipate locomotor stresses, yet farriery approaches are utilised to increase performance and protect hooves from wear. Previous studies have assessed the effect of different shoe designs on locomotor performance; however, no biomechanical study has hitherto measured the effect of horseshoes on the stresses of the foot skeleton in vivo. This preliminary study introduces a novel methodology combining three-dimensional data from biplanar radiography with inverse dynamics methods and finite element analysis (FEA) to evaluate the effect of a stainless steel shoe on the function of a Thoroughbred horse’s forefoot during walking. Our preliminary results suggest that the stainless steel shoe shifts craniocaudal, mediolateral and vertical GRFs at mid-stance. We document a similar pattern of flexion-extension in the PIP (pastern) and DIP (coffin) joints between the unshod and shod conditions, with slight variation in rotation angles throughout the stance phase. For both conditions, the PIP and DIP joints begin in a flexed posture and extend over the entire stance phase. At mid-stance, small differences in joint angle are observed in the PIP joint, with the shod condition being more extended than the unshod horse, whereas the DIP joint is extended more in the unshod than the shod condition. We also document that the DIP joint extends more than the PIP after mid-stance and until the end of the stance in both conditions. Our FEA analysis, conducted solely on the bones, shows increased von Mises and Maximum principal stresses on the forefoot phalanges in the shod condition at mid-stance, consistent with the tentative conclusion that a steel shoe might increase mechanical loading. However, because of our limited sample size none of these apparent differences have been tested for statistical significance. Our preliminary study illustrates how the shoe may influence the dynamics and mechanics of a Thoroughbred horse’s forefoot during slow walking, but more research is needed to quantify the effect of the shoe on the equine forefoot during the whole stance phase, at faster speeds/gaits and with more individuals as well as with a similar focus on the hind feet. We anticipate that our preliminary analysis using advanced methodological approaches will pave the way for new directions in research on the form/function relationship of the equine foot, with the ultimate goal to minimise foot injuries and improve animal health and welfare. PMID:27478694

Role of neuropathy and high foot pressures in diabetic foot ulceration.

PubMed

Frykberg, R G; Lavery, L A; Pham, H; Harvey, C; Harkless, L; Veves, A

1998-10-01

High plantar foot pressures in association with peripheral neuropathy have been ascertained to be important risk factors for ulceration in the diabetic foot. Most studies investigating these parameters have been limited by their size and the homogeneity of study subjects. The objective of this study was therefore to ascertain the risk of ulceration associated with high foot pressures and peripheral neuropathy in a large and diverse diabetic population. We studied a cross-sectional group of 251 diabetic patients of Caucasian (group C) (n=121), black (group B) (n=36), and Hispanic (group H) (n=94) racial origins with an overall age of 58.5+/-12.5 years (range 20-83). There was an equal distribution of men and women across the entire study population. All patients underwent a complete medical history and lower extremity evaluation for neuropathy and foot pressures. Neuropathic parameters were dichotomized (0/1) into two high-risk variables: patients with a vibration perception threshold (VPT) > or =25 V were categorized as HiVPT (n=132) and those with Semmes-Weinstein monofilament tests > or =5.07 were classified as HiSWF (n=190). The mean dynamic foot pressures of three footsteps were measured using the F-scan mat system with patients walking without shoes. Maximum plantar pressures were dichotomized into a high-pressure variable (Pmax6) indicating those subjects with pressures > or =6 kg/cm2 (n=96). A total of 99 patients had a current or prior history of ulceration at baseline. Joint mobility was significantly greater in the Hispanic cohort compared with the other groups at the first metatarsal-phalangeal joint (C 67+/-23 degrees, B 69+/-23 degrees, H 82+/-23 degrees, P=0.000), while the subtalar joint mobility was reduced in the Caucasian group (C 21+/-8 degrees, B 26+/-7 degrees, H 27+/-11 degrees, P=0.000). Maximum plantar foot pressures were significantly higher in the Caucasian group (C 6.7+/-2.9 kg/cm2, B 5.7+/-2.8 kg/cm2, H 4.4+/-1.9 kg/cm2, P=0.000). Univariate logistic regression for Pmax6 on the history of ulceration yielded an odds ratio (OR) of 3.9 (P=0.000). For HiVPT, the OR was 11.7 (P=0.000), and for HiSWF the OR was 9.6 (P=0.000). Controlling for age, diabetes duration, sex, and race (all P < 0.05), multivariate logistic regression yielded the following significant associations with ulceration: Pmax6 (OR=2.1, P=0.002), HiVPT (OR=4.4, P=0.000), and HiSWF (OR=4.1, P=0.000). We conclude that both high foot pressures (> or =6 kg/cm2) and neuropathy are independently associated with ulceration in a diverse diabetic population, with the latter having the greater magnitude of effect. In black and Hispanic diabetic patients especially, joint mobility and plantar pressures are less predictive of ulceration than in Caucasians.

Fingers' vibration transmission and grip strength preservation performance of vibration reducing gloves.

PubMed

Hamouda, K; Rakheja, S; Dewangan, K N; Marcotte, P

2018-01-01

The vibration isolation performances of vibration reducing (VR) gloves are invariably assessed in terms of power tools' handle vibration transmission to the palm of the hand using the method described in ISO 10819 (2013), while the nature of vibration transmitted to the fingers is ignored. Moreover, the VR gloves with relatively low stiffness viscoelastic materials affect the grip strength in an adverse manner. This study is aimed at performance assessments of 12 different VR gloves on the basis of handle vibration transmission to the palm and the fingers of the gloved hand, together with reduction in the grip strength. The gloves included 3 different air bladder, 3 gel, 3 hybrid, and 2 gel-foam gloves in addition to a leather glove. Two Velcro finger adapters, each instrumented with a three-axis accelerometer, were used to measure vibration responses of the index and middle fingers near the mid-phalanges. Vibration transmitted to the palm was measured using the standardized palm adapter. The vibration transmissibility responses of the VR gloves were measured in the laboratory using the instrumented cylindrical handle, also described in the standard, mounted on a vibration exciter. A total of 12 healthy male subjects participated in the study. The instrumented handle was also used to measure grip strength of the subjects with and without the VR gloves. The results of the study showed that the VR gloves, with only a few exceptions, attenuate handle vibration transmitted to the fingers only in the 10-200 Hz and amplify middle finger vibration at frequencies exceeding 200 Hz. Many of the gloves, however, provided considerable reduction in vibration transmitted to the palm, especially at higher frequencies. These suggest that the characteristics of vibration transmitted to fingers differ considerably from those at the palm. Four of the test gloves satisfied the screening criteria of the ISO 10819 (2013) based on the palm vibration alone, even though these caused amplification of handle vibration at the fingers. The fingers' vibration transmission performance of gloves were further evaluated using a proposed finger frequency-weighting W f apart from the standardized W h -weighting. It is shown that the W h weighting generally overestimates the VR glove effectiveness in limiting the fingers vibration in the high (H: 200-1250 Hz) frequency range. Both the weightings, however, revealed comparable performance of gloves in the mid (M: 25-200 Hz) frequency range. The VR gloves, with the exception of the leather glove, showed considerable reductions in the grip strength (27-41%), while the grip strength reduction was not correlated with the glove material thickness. It is suggested that effectiveness of VR gloves should be assessed considering the vibration transmission to both the palm and fingers of the hand together with the hand grip strength reduction. Copyright © 2017 Elsevier Ltd. All rights reserved.

Directional fractal signature methods for trabecular bone texture in hand radiographs: Data from the Osteoarthritis Initiative

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wolski, M., E-mail: marcin.wolski@curtin.edu.au; Podsiadlo, P.; Stachowiak, G. W.

Purpose: To develop directional fractal signature methods for the analysis of trabecular bone (TB) texture in hand radiographs. Problems associated with the small size of hand bones and the orientation of fingers were addressed. Methods: An augmented variance orientation transform (AVOT) and a quadrant rotating grid (QRG) methods were developed. The methods calculate fractal signatures (FSs) in different directions. Unlike other methods they have the search region adjusted according to the size of bone region of interest (ROI) to be analyzed and they produce FSs defined with respect to any chosen reference direction, i.e., they work for arbitrary orientation ofmore » fingers. Five parameters at scales ranging from 2 to 14 pixels (depending on image size and method) were derived from rose plots of Hurst coefficients, i.e., FS in dominating roughness (FS{sub Sta}), vertical (FS{sub V}) and horizontal (FS{sub H}) directions, aspect ratio (StrS), and direction signatures (StdS), respectively. The accuracy in measuring surface roughness and isotropy/anisotropy was evaluated using 3600 isotropic and 800 anisotropic fractal surface images of sizes between 20 × 20 and 64 × 64 pixels. The isotropic surfaces had FDs ranging from 2.1 to 2.9 in steps of 0.1, and the anisotropic surfaces had two dominating directions of 30° and 120°. The methods were used to find differences in hand TB textures between 20 matched pairs of subjects with (cases: approximate Kellgren-Lawrence (KL) grade ≥2) and without (controls: approximate KL grade <2) radiographic hand osteoarthritis (OA). The OA Initiative public database was used and 20 × 20 pixel bone ROIs were selected on 5th distal and middle phalanges. The performance of the AVOT and QRG methods was compared against a variance orientation transform (VOT) method developed earlier [M. Wolski, P. Podsiadlo, and G. W. Stachowiak, “Directional fractal signature analysis of trabecular bone: evaluation of different methods to detect early osteoarthritis in knee radiographs,” Proc. Inst. Mech. Eng., Part H 223, 211–236 (2009)]. Results: The AVOT method correctly quantified the isotropic and anisotropic surfaces for all image sizes and scales. Values of FS{sub Sta} were significantly different (P < 0.05) between the isotropic surfaces. Using the VOT and QRG methods no differences were found at large scales for the isotropic surfaces that are smaller than 64 × 64 and 48 × 48 pixels, respectively, and at some scales for the anisotropic surfaces with size 48 × 48 pixels. Compared to controls, using the AVOT and QRG methods the authors found that OA TB textures were less rough (P < 0.05) in the dominating and horizontal directions (i.e., lower FS{sub Sta} and FS{sub H}), rougher in the vertical direction (i.e., higher FS{sub V}) and less anisotropic (i.e., higher StrS) than controls. No differences were found using the VOT method. Conclusions: The AVOT method is well suited for the analysis of bone texture in hand radiographs and it could be potentially useful for early detection and prediction of hand OA.« less

Pycnodysostosis at otorhinolaryngology.

PubMed

Baglam, Tekin; Binnetoglu, Adem; Fatih Topuz, Muhammet; Baş Ikizoglu, Nilay; Ersu, Refika; Turan, Serap; Sarı, Murat

2017-04-01

Pycnodysostosis is a rare autosomal, recessive, skeletal dysplasia caused by a mutation in the cathepsin k gene. Pycnodysostosis is characterized by short stature, characteristic facial appearance (delayed closure of fontanelles and cranial sutures, mandibular hypoplasia and angle disorder, blue sclera), and acroosteolysis of the distal phalanges. Our aim was to describe the otorhinolaryngologic findings, differential diagnoses, various treatment options, and followup in eight cases of pycnodysostosis. This retrospective clinical study used data from eight patients diagnosed with pycnodysostosis by a single pediatric endocrinologist primarily based on clinical and radiographic findings. All patients were referred to the otorhinolaryngology outpatient clinic by the pediatric endocrinology unit of the Marmara University between February 2013 and March 2015. Detailed medical histories were obtained in all cases and otorhinolaryngologic physical examination, blood assays, electrocardiogram, lateral skull X-rays, chest radiograph, cephalometric investigations, tympanograms, and audiograms were also carried out. Sleep videos of patients were recorded and those with upper airway problems were evaluated for sleep apnea by polysomnography. Informed consent form was obtained from the parents of all patients. Eight patients (7 females and 1 male) displaying proportionate dwarfism were included in the study. They had a mean age of 14.7 years (range: 13-16 y), the mean height of 141.3 cm (range 132-155 cm), and mean weight of 44.4 kg (range: 39.6-49.3 kg). All patients had facial dysmorphism with frontal bossing and the hands and feet had short digits with overlying cutaneous wrinkles that tapered off with large overriding nails. Midfacial hypoplasia and malocclusion were observed in seven of the eight patients (87.5%), four (50%) had micrognathia, and five (62.5%) had proptosis. Tympanograms and audiograms of all patients were type A and normal, and the mean of the pure tone audiogram was 13.3 dB (range: 10-16 dB). All patients had a narrow and grooved palate with disturbed dentition; two of them (25%) had mild markedness of the tongue base, five (62.5%) had grade 3 and three (37.5%) had grade 2 tonsillar hypertrophy, and five (62.5%) had adenoid hypertrophy. One patient (12.5%) had grade 3 Mallampati, four (50%) showed grade 2 Mallampati while three (37.5%) patients displayed grade 1 Mallampati score. Further, while six (75%) patients had no uvular pathology, one (12.5%) patient presented with uvular elongation and another patient had a bifid uvula. Cephalometric measurements such as PAS-UP (mean 5.67 mm; range: 5.0-7.6 mm) and PAS-TP (mean 9.61 mm; range: 8.5-12.2 mm) were lower than that of normal subjects. Video recordings showed that six of the eight patients (75%) had respiratory distress and four (50%) had sleep apnea. Polysomnography in these patients with sleep apnea showed that two had mild OSA (AHI: 18.2 and 20.1 events/hour) and two had severe OSA (AHI: 53.4 and 62.8 events/hour). For upper airway problems, an adenotonsillectomy was performed in two (25%) patients while two others required an adenoidectomy. Positive pressure ventilation was recommended in two patients with persistent sleep apnea after adeno/adenotonsillectomy. However, because of the parental objections, the follow-up polysomnographs could not be obtained. Pycnodysostosis is a very rare form of bone dysplasia. Otorhinolaryngologically, proper follow-up of these patients and appropriate treatment of upper airway problems are important to achieve an acceptable quality of life. Adeno/adenotonsillectomy and positive pressure ventilation, used as conservative approaches in treating upper airway problems, are effective and could be used instead of an aggressive surgery such as tracheotomy or maxillomandibular advancement. This study, to the best of our knowledge, is the largest ENT case series on pycnodysostosis. Copyright © 2017 Elsevier B.V. All rights reserved.

Diffuse Palmoplantar Keratoderma, Onychodystrophy, universal Hypotrichosis and Cysts.

PubMed

Arif, Tasleem; Amin, Syed Suhail; Adil, Mohammad; Mohtashim, Mohd

2017-07-01

Dear Editor, Clouston syndrome, also called hidrotic ectodermal dysplasia (HED), is an autosomal dominant ectodermal dysplasia characterized by a clinical triad of onychodystrophy, generalized hypotrichosis, and palmoplantar keratoderma (1). Herein we report the case of a 24-year-old male with the distinctive clinical triad associated with multiple epidermoid cysts, which probably reflects the phenotype of Clouston syndrome. A 24-year-old male presented to our Department with diffuse thickening of the skin of his palms and soles since infancy. He also complained of sparsity to near absence of body hair and also reported thickening of the nails and multiple swellings involving the genitals and head since childhood. There was no history of consanguinity or of recurrent painful paronychia or abnormality in sweating. The patient denied any history of deafness, diminution of vision, redness, or watering of the eyes. On examination, diffuse hyperkeratosis of the palms and soles was observed (Figure 1 a, b) However, there was no extension of this hyperkeratosis to the dorsal aspects of the hands and feet or any proximal extension to the forearms or legs. Extensor aspects of the elbows and knees did not reveal any hyperkeratotic skin lesions. The nails were yellowish-brown, thickened, and hyperconvex, which was more pronounced in the finger nails than the toe nails (Figure 1 c, d). There was no associated paronychia. The scalp hair was very sparse, fine, and pale in color, reaching just a length of 3-4 mm in some places while totally absent in other places. The hair from the beard, eyebrows, eyelashes, moustaches, and pubic and axillary regions was very sparse to nearly absent (Figure 2 a, b, c). General body hair was also absent. In the left pre-auricular area there was a 3×2.5 cm swelling, soft to firm in consistency, non-tender, and non-pulsatile with no sinus or scar over it (Figure 2c). Multiple similar swellings of variable size measuring 0.6 to 1.3 cm were present over the scrotum (Figure 2 d). Systemic examination including oro-dental and ophthalmological examination was unremarkable. Physical tests for hearing were normal. Nail clippings for KOH examination did not reveal any fungal components. Fine needle aspiration from the pre-auricular swelling was consistent with epidermoid cyst. The classical triad of onychodystrophy, universal hypotrichosis, and palmoplantar hyperkeratosis with normal sweating and teeth indicated a diagnosis of Clouston syndrome. Hidrotic ectodermal dysplasia was first described in a French-Canadian kindred (2). However, it has subsequently been described in other ethnic and geographical areas. There is a mutation in the β gap junction protein gene which codes for the protein connexin 30 (Cx30) (3). This condition primarily affects the hair, nails, and skin, while sparing the teeth and sweat glands. The hair is sparse and pale, and the alopecia can be patchy or total. Hair loss may lead to total alopecia by puberty. The eyelashes are short and sparse, and the eyebrows as well as axillary and pubic hair are also sparse or absent (1), as in our case. During infancy, the nails are typically milky white, gradually thickening throughout childhood. The nail plate is short, thick, slow-growing, and discolored, which was consistent with our patient's nail changes. Diffuse palmoplantar hyperkeratosis is a characteristic sign which may extend to the dorsum of the hands and feet (4). However, our case had no transgradient component. There are other less common abnormalities reported in Clouston syndrome, which include conjunctivitis, strabismus, congenital cataract, oral leucoplakia, diffuse eccrine poromatosis, sensorineural hearing loss, thickened skull bones, and tufting of the terminal phalanges (2,5-8). However, to the best of our knowledge, the presence of epidermoid cysts in Clouston syndrome has not been previously reported, making our case a unique clinical presentation. Pachyonychia congenita is a very close differential diagnosis for this entity. However, universal hypotrichosis and the lack of oral leukokeratosis were the differentiating features in our case. Additionally, palmoplantar keratoderma in pachyonychia congenita is mainly focal rather than diffuse, as in our case. However, genetic studies are needed to establish such a diagnosis.

Ep6_ The Most Awesome Podcast from Space

NASA Image and Video Library

2017-08-11

>> HOUSTON, WE HAVE A PODCAST. WELCOME TO THE OFFICIAL PODCAST OF THE NASA JOHNSON SPACE CENTER, EPISODE 6: THE MOST AWESOME PODCAST FROM SPACE. I’M GARY JORDAN, AND I’LL BE YOUR CO-HOST TODAY, ALONG WITH DAN HEWITT. DAN, WHAT’S UP? >> HEY, GARY. TODAY’S EPISODE WAS A LITTLE DIFFERENT, BECAUSE WE HAD A CONVERSATION WITH JACK FISCHER, A US ASTRONAUT, WHILE HE WAS IN SPACE. AND WE DID THE WHOLE THING LIVE, SO WE BROUGHT IN SOME SOCIAL MEDIA QUESTIONS REAL TIME, AND JACK WAS ANSWERING THEM. >> THAT’S RIGHT, IT WAS A WICKED AWESOME DISCUSSION ABOUT WHAT IT’S LIKE TO LIVE IN SPACE, WORK ON SCIENCE EXPERIMENTS, AND SEE THE EARTH BELOW WHILE YOU’RE TRAVELLING AT 17,500 MILES PER HOUR, WATCHING THE SUN RISE AND SET 16 TIMES A DAY. SUCH A UNIQUE PERSPECTIVE OF THE PLANET. SO, WITH NO FURTHER DELAY, LET’S GO LIGHT SPEED AND JUMP RIGHT INTO OUR TALK WITH COLONEL JACK FISCHER. ENJOY. [ MUSIC ] >> T MINUS FIVE SECONDS AND COUNTING. MARK. [ INDISTINCT RADIO CHATTER ] >> WE HAVE A PODCAST! [ MUSIC ] >> IT’S REAL GOOD TO BE BACK. I WAS ON THE FIRST EPISODE, AND I’M NOT THE EXPERT-- WE ARE TALKING TO THE EXPERT IN SPACE TODAY. IT’S SUPER EXCITING, AND AGAIN, JUST WRAP YOUR MIND AROUND THAT-- WE’RE ABOUT TO TALK TO SOMEBODY IN OUTER SPACE. >> I-- YEAH, HOW COOL IS THAT? IT’S CRAZY! I MEAN, WE’RE LOOKING AT HIM RIGHT NOW GETTING SET UP. THIS IS CRAZY. I MEAN, FOR ME PERSONALLY, THIS IS MY VERY FIRST TIME TALKING TO SOMEBODY IN SPACE. >> THAT’S RIGHT, GARY’S NEWER HERE, SO HE HASN’T HAD THE PRIVILEGE. I’VE BEEN HERE A LITTLE BIT LONGER, AND I’VE DONE IT MAYBE ONCE OR TWICE STILL, BUT IT’S STILL REALLY EXCITING. IT MAKES YOU A LITTLE BIT NERVOUS, BUT IT’S REALLY COOL TO LIVE IN A TIME WHERE WE HAVE THE CAPABILITIES TO TALK TO SOMEBODY WHO’S IN OUTER SPACE, FLYING AROUND US AT 17,000 MILES AN HOUR. I MEAN, ONE OF THE COOLEST EXAMPLES I CAN THINK OF THAT HAPPENING-- AND IT SHOWS YOU JUST HOW FAR WE’VE COME. I MEAN, IT USED TO BE YOU NEEDED SATELLITE DISHES AND TECHNOLOGY THAT WE HAD MILLIONS OF POUNDS OF ALL OF THESE THINGS JUST TO TALK TO SOMEBODY A FEW HUNDRED MILES AWAY. AND NOW, YOU COULD TALK TO SOMEBODY IN SPACE ON A CELL PHONE. IT ACTUALLY HAPPENED TO US ONCE. WE WERE OVER IN KAZAKHSTAN, AND WE HAD JUST WATCHED ONE OF THE CREWS LAUNCH TO THE INTERNATIONAL SPACE STATION. AND IT HAD BEEN A COUPLE OF HOURS, THEY WERE ALMOST DOCKED, AND WE WERE HEADING TO AN OLD THEATER IN BAIKONUR TO GO WATCH THE ACTUAL DOCKING OF THE CREW MEMBERS GET THERE, AND ONE OF MY COLLEAGUES’ PHONES RANG. AND HE ANSWERED IT, AND YOU COULD JUST SEE HIS FACE LIGHT UP. AND IT WAS JUST A REAL SHORT CONVERSATION-- “OH, YEAH, NO, THAT SOUNDS GREAT. SOUNDS COOL, YEAH. WE’LL DEFINITELY USE THAT.” THAT WAS IT-- HE HUNG UP. AND HE SAID, “THAT WAS THE COMMANDER OF THE INTERNATIONAL SPACE STATION. HE JUST CALLED ME ON MY CELL PHONE TO TELL ME HOW HE WAS SETTING UP A CAMERA TO WATCH THE CREW MEMBERS COME ONBOARD.” SO I MEAN, JUST THAT BLEW MY MIND, BECAUSE WE WERE JUST IN THIS REMOTE PART OF THE PLANET, AND HE COULD GET A PHONE CALL FROM SOMEBODY IN SPACE. LIKE, IT’S JUST SO INCREDIBLE THAT WE’RE LIVING IN THIS TIME. AND WE’RE ABOUT TO TALK TO SOMEBODY IN SPACE. IF YOU CAN’T TELL, I’M REALLY EXCITED. [ LAUGHTER ] AND I KNOW GARY IS, TOO. >> YEAH, VERY, VERY TRUE. IT’S JUST CRAZY TO PICK UP A BOX AND THEN LITERALLY, IT IS SPACE CALLING. I’VE HEARD STORIES OF, YOU KNOW, ASTRONAUTS CALLING PIZZA JOINTS AND ORDERING PIZZA FOR SOME COLLEAGUE WHOSE BIRTHDAY IT WAS, OR SOMETHING LIKE THAT. IT’S JUST THE MOST INSANE THING TO THINK ABOUT. BUT OKAY, SO TODAY, WE’RE TALKING WITH SOMEBODY IN SPACE-- JACK FISCHER. >> YES. >> LET’S TALK A LITTLE BIT ABOUT HIM. WHO IS THIS GUY? >> SO JACK FISCHER IS ONE OF THE FLIGHT ENGINEERS FOR EXPEDITION 52. HE’S BEEN ONBOARD THE INTERNATIONAL SPACE STATION SINCE APRIL, SINCE HE LAUNCHED WITH THE RUSSIAN COSMONAUT FYODOR YURCHIKHIN. JACK IS ONE OF THE RELATIVELY NEWER ASTRONAUTS IN THE CORPS. HE WAS SELECTED BACK IN 2009, AND THIS IS HIS FIRST SPACEFLIGHT, SO THIS IS HIS FIRST TIME IN SPACE. AND HE’S BEEN UP THERE FOR A COUPLE OF MONTHS NOW. HE’S GOT A STEM BACKGROUND LIKE ALL OF THE ASTRONAUTS DO-- DEGREES IN AERONAUTICAL ENGINEERING, AERONAUTICS AND ASTRONAUTICS-- A LOT OF A WORDS IN THERE. AND HE WENT TO MIT, SO HE’S GOT A PRETTY NICE RESUME TO MAKE HIM AN ASTRONAUT. BUT HE WAS ALSO IN THE AIR FORCE-- HE’S AN AIR FORCE COLONEL WITH 3,000 FLIGHT HOURS AND MORE THAN 45 DIFFERENT AIRCRAFT. AND HE WORKED IN A WHOLE BUNCH OF DIFFERENT JOBS BEFORE HE EVER FLEW INTO SPACE. AND ALL THE ASTRONAUTS DO THAT-- THEY’RE EITHER SUPPORTING DIFFERENT TECHNICAL PROGRAMS HERE AT NASA-- JACK WAS A CAPCOM, SO HE WAS ONE OF THE PEOPLE WHO ACTUALLY TALKS TO ASTRONAUTS EVERY SINGLE DAY. >> OH, WOW. >> SO YOU KNOW, FOR PEOPLE LIKE THAT, TALKING TO SOMEBODY IN SPACE IS THEIR JOB, IT’S OLD HAT. FOR US, IT’S SUPER UNIQUE, BUT… HE’S DONE ALL THOSE THINGS, AND NOW HE’S BEEN ONBOARD FOR THE LAST COUPLE OF MONTHS, AND HE’S BEEN DOING EVERYTHING FROM SPACEWALKING, TO SCIENCE, TO CAPTURING VISITING SPACECRAFT-- KIND OF THE WHOLE GAMBIT OF STUFF. >> UNBELIEVABLE! OKAY, SO HE’S-- YOU KNOW, NOW HE’S GOT THAT EXPERIENCE, RIGHT? HE’S GOT NOT ONLY THE FLIGHT TIME JUST IN PLANES, BUT NOW HE’S GOT FLIGHT TIME TRAVELLING 250 MILES ABOVE THE EARTH REALLY, REALLY FAST. SO HE’S GOT-- SO HOW ARE HIS SPACEWALKS? WHAT’S THAT? >> YEAH, SO HE DID TWO SPACEWALKS. AND EVERY ASTRONAUT WILL TELL YOU THAT SPACEWALKS ARE ONE OF THE MOST UNIQUE, ONE OF THE MOST DYNAMIC THINGS THEY GET TO DO. IT’S KIND OF ONE OF THE COOLEST THINGS ABOUT BEING IN SPACE A LOT OF TIMES. AND HE DID TWO BACK IN MAY. ONE, THEY JUST REPLACED A COMPONENT ON THE OUTSIDE, AND THE OTHER ONE WAS SOMETHING WE CALL AN UNPLANNED SPACEWALK, WHERE SOMETHING BROKE AND THEY HAD TO GO OUTSIDE AND REPLACE IT. AND SO HE DID BOTH OF THOSE WITH PEGGY WHITSON, WHO’S BEEN UP THERE WITH HIM THE WHOLE TIME. HE AFFECTIONATELY REFERS TO HER AS THE SPACE NINJA. [ LAUGHTER ] SHE IS THE ALL-TIME RECORD HOLDER FOR AMERICAN ASTRONAUTS FOR TIME IN SPACE, SO DEFINITELY A GOOD PERSON TO HAVE UP THERE WITH YOU ON YOUR FIRST TRIP. >> FOR SURE. [ LAUGHTER ] AWESOME. OKAY, SO WE ARE GOING TO BE TALKING TO JACK FISCHER HERE IN JUST A FEW MINUTES. IF YOU ARE TUNING IN ON FACEBOOK LIVE, WE ARE ACTUALLY MONITORING THE QUESTIONS RIGHT HERE, AND GOING TO ANSWER THEM AS THEY COME ALONG, MAYBE EVEN SEND A COUPLE UP TO JACK ONCE WE GET STARTED HERE. SO WE HAVE A COUPLE HERE COMING IN ALREADY. WE HAVE FOLKS CHECKING IN FROM ALL OVER THE WORLD. I SEE SOME FROM ITALY. I SEE SOME FROM, OBVIOUSLY, HERE IN THE STATES. SO EVERYONE, WELCOME. I DID SEE ONE QUESTION, ACTUALLY, BEFORE WE EVEN STARTED THIS ONE. THIS ONE IS FROM KELLY, AND SHE SAID HER FIVE-YEAR-OLD WAS ASKING IF SOME OF THE ASTRONAUTS WATCH MOVIES ON THE INTERNATIONAL SPACE STATION. >> THEY DO, THEY DO. WE DO LIKE TO EQUIP THEM WITH SOME OF THE KIND OF CREATURE COMFORTS OF BEING BACK HERE AT HOME. >> COOL. >> AND ONE THING THEY HAVE UP THERE IS THEY ACTUALLY HAVE A VERY SMALL PROJECTOR, AND THEN A LARGE SCREEN-- I THINK IT’S ABOUT 40 INCHES OR SO-- AND THEY’LL HAVE MOVIE NIGHTS. AND WE ACTUALLY DO HAVE A PICTURE. >> AW, LOOK AT THIS! >> AND THIS IS ALL SIX CREW MEMBERS. THEY USE BUNGEE CORDS TO KIND OF MAKE LITTLE LEAN-TO HAMMOCKS, AND EVEN BREAKING OUT THEIR SLEEPING BAGS TO GATHER TOGETHER AND WATCH MOVIES IN SPACE. A LOT OF THEM WILL TELL YOU THEY LIKE TO WATCH A LOT OF SPACE MOVIES, JUST BECAUSE, I MEAN, THEY’RE UP THERE, THEY’RE LIVING IT. >> SURE. >> BUT IT’S JUST ONE OF THOSE THINGS THAT KIND OF MAKES LIVING IN SPACE A LITTLE MORE LIKE BEING BACK HERE AT HOME. BECAUSE, I MEAN, YOU’RE IN A REALLY STRANGE PLACE. >> IT’S TRUE. >> I MEAN, YOU’RE COMPLETELY ISOLATED FROM EVERYBODY EXCEPT FOR THE TWO OR FIVE PEOPLE WITH YOU. SO HAVING THINGS LIKE MOVIES CAN MAKE THAT TIME A LOT EASIER. >> NOW, IT SEEMS LIKE COMRADERY HAS GOT TO BE ONE OF THE IMPORTANT ASPECTS OF LIVING IN SPACE, TOO-- JUST GETTING ALONG WITH YOUR CREWMATES AND DOING STUFF TOGETHER. I KNOW-- I GUESS THEY WATCH MOVIES TOGETHER, AS WE JUST SAW IN THAT PICTURE, BUT I KNOW THEY EAT MEALS TOGETHER, TOO. >> OH YEAH, THEY DO. AND THEY’RE TOGETHER FOR YEARS BEFORE THEY EVER FLY. THEY’LL USUALLY BE WITH-- YOU’LL BE WITH THE SAME PEOPLE PRETTY MUCH THROUGHOUT ALL YOUR WORK TIME FOR TWO YEARS BEFORE YOU FLY IN SPACE WITH THEM. SO THEY KNOW EACH OTHER VERY WELL BEFORE THEY FLY. MEALS ARE DEFINITELY ONE OF THOSE-- SO IT’S AN INTERNATIONAL SPACE STATION, SO THERE’S A LOT OF INTERNATIONAL FOODS. SO THEY LIKE TO COME TOGETHER AND SHARE LITTLE CREATIONS. THE FOOD’S NOT QUITE AS GOURMET AS IT MIGHT BE DOWN HERE ON EARTH, BUT THEY DO HAVE A COUPLE OF WAYS TO MAKE IT A LITTLE BIT MORE INTERESTING-- THEY LIKE TO PUT HOT SAUCES AND THINGS LIKE THAT ON A TON OF STUFF, JUST BECAUSE YOUR TASTE ACTUALLY CHANGES WHEN YOU’RE IN SPACE. AND THAT’S DUE TO ALL THE FLUIDS RUSHING UP, AND A WHOLE BUNCH OF CRAZY THINGS HAPPEN, BUT-- >> WOW. >> YEAH. >> ALL RIGHT, WELL, IF YOU HAVE ANY MORE QUESTIONS FOR JACK, JUST PUT THEM IN THE COMMENT SECTION. WE’LL KIND OF FOLLOW ALONG AND EVEN-- HE’S GETTING SET UP HERE RIGHT NOW, BUT ONCE WE START CONNECTING WITH HIM IN JUST A FEW MINUTES HERE, WE’LL READ THOSE QUESTIONS UP TO HIM. BUT PERSONALLY, FOR ME, I MEAN, BESIDES JUST YOU READING HIS BIO, THIS IS THE FIRST TIME I’VE MET JACK. I’M-- THE FIRST TIME I’M ACTUALLY GOING TO BE TALKING TO HIM. >> SO JACK-- HIGHLY RECOMMEND FOLLOWING HIM ON SOCIAL MEDIA. HE’S BROUGHT JUST AN INCREDIBLE AMOUNT OF EXCITEMENT TO EVERYTHING THAT HE’S BEEN DOING. AND AGAIN, HE’S A FIRST TIMER, SO HE’S BEEN EXPERIENCING ALL THIS FOR THE FIRST TIME AND SHARING IT WITH PEOPLE AS HE DID. I ACTUALLY GOT TO MEET JACK THREE YEARS AGO. WE WERE BOTH DOWN IN FLORIDA FOR ORION’S FIRST SPACEFLIGHT, EFT 1. IT WAS THE FIRST TIME WE PUT ORION, OUR NEXT GENERATION SPACECRAFT, INTO OUTER SPACE. AND HE WAS BASICALLY ASSIGNED TO BE OUR VOICE FOR THE ENTIRE AGENCY. SO HE WENT AROUND TALKING TO THE MEDIA, ALL OF THESE DIFFERENT PEOPLE TO TELL THEM ABOUT ORION. AND AGAIN, HE JUST BRINGS THIS LEVEL OF ENTHUSIASM. HE’S GOT A GREAT SENSE OF HUMOR. HE’S INCREDIBLY KNOWLEDGEABLE, SO HE’S GOING TO BE GREAT FOR THIS, THE MOST AWESOME PODCAST FROM SPACE. SO I’M SUPER EXCITED. >> ABSOLUTELY. APPROPRIATELY NAMED, TOO. THAT’S WHAT WE’RE GOING TO BE CALLING THIS EPISODE. SO WE’LL TALK TO HIM RIGHT NOW. THIS WILL BE OUR LIVE EPISODE THAT WE’LL BE DOING HERE. YOU’LL BE ABLE TO INTERACT WITH US LIVE, BUT THEN IT’LL BE AVAILABLE ON iTUNES, SOUNDCLOUD, AND NASA.GOV-- THE RECORDED AUDIO VERSION AFTER THIS. I GUESS TOMORROW WE’LL POST IT. SO THERE’LL BE A FULL TRANSCRIPT WITH THAT AS WELL. SO RIGHT NOW-- >> WE’RE 20 SECONDS AWAY. >> OH, OKAY. >> WE’RE ABOUT 20 SECONDS AWAY. GARY, ARE YOU READY? ARE YOU READY TO TALK TO SPACE FOR THE VERY FIRST TIME? >> I THINK SO, I THINK SO. >> ARE YOU READY? OKAY, EVERYBODY, LET’S GET READY FOR GARY. THIS CAN BE A LITTLE NERVE-RACKING, I ASSURE YOU, BUT-- [ LAUGHTER ] JUST A COUPLE OF SECONDS. >> OKAY, SO WE’LL WAIT FOR THE CALL FROM MISSION CONTROL HOUSTON HERE, AND START TALKING TO JACK SOON. >> STATION, THIS IS HOUSTON. ARE YOU READY FOR THE EVENT? >> I SURE AM. >> JSC PAO, THIS IS MISSION CONTROL HOUSTON. PLEASE CALL STATION FOR A VOICE CHECK. >> STATION, THIS IS GARY JORDAN AND DAN HEWITT HERE FOR “HOUSTON, WE HAVE A PODCAST.” HOW DO YOU HEAR ME? >> LOUD AND CLEAR, GARY AND DAN. GREAT TO BE WITH YOU TODAY. >> AWESOME. WELL, I AM EXTREMELY EXCITED ABOUT THIS EPISODE, BECAUSE AS I WAS TELLING DAN HERE BEFOREHAND, THIS IS-- USUALLY WHEN WE HAVE A GUEST, THEY’RE IN THE STUDIO, LET ALONE ON THE PLANET. SO I’M GOING TO START OFF THIS CONVERSATION BY ASKING SOMETHING THAT I LITERALLY CANNOT ASK ANYONE ELSE: HOW’S LIFE IN SPACE TODAY? >> IT’S AWESOME, LIKE IT IS EVERY DAY! AND WHAT I WAS GOING TO DO-- JUST BECAUSE, YOU KNOW, IT IS YOUR FIRST GUEST FROM SPACE-- EVERY SINGLE QUESTION, I’M GOING TO GO ON A DIFFERENT WALL. [ LAUGHTER ] SO I’LL BE ON THE WALLS, I’LL BE ON THE CEILING. I’M GOING TO ADJUST ORIENTATION MID-INTERVIEW AT EVERY QUESTION, JUST BECAUSE I CAN, AND IT’S COOL. I LOVE IT. OKAY, AWESOME. SO YOU’RE USED TO SPACE NOW. YOU’VE BEEN UP THERE FOR-- WHAT IS IT-- ALMOST FOUR MONTHS. >> YEAH. >> SO I MEAN, WHEN YOU’RE GOING TO BE SWITCHING FROM WALL TO WALL, DO YOU SORT OF GET DISORIENTED, OR IS YOUR BODY USED TO IT AT THIS POINT? >> NAH, IT KIND OF FIGURED IT OUT PRETTY QUICK, AND YOU KNOW, THAT’S WHAT’S SO AWESOME ABOUT THE HUMAN BRAIN. WE COME UP HERE IN A COMPLETELY FOREIGN ENVIRONMENT, AND THE BRAIN’S JUST LIKE, “MAN, ALL THIS VESTIBULAR-- ALL THESE THINGS THAT I NORMALLY USE TO FIGURE OUT WHICH WAY’S UP AND TO ORIENT THIS BODY FOR THIS DUDE DOESN’T WORK. SO I HAVE TO FIND A DIFFERENT WAY.” SO IT FORCES YOUR MIND AND YOUR BODY TO GROW AND TO LOOK AT THINGS DIFFERENTLY. SO YOU START LOOKING THREE-DIMENSIONALLY AT EVERYTHING AROUND YOU, AND IT’S AMAZING HOW QUICKLY YOUR BODY CAN ADAPT AND JUST GET USED TO IT. ALL RIGHT, THAT WAS QUESTION ONE-- I’VE GOT TO SWITCH NOW. [ LAUGHTER ] >> ALL RIGHT, WELL, WHILE YOU DO THAT, I MEAN, THAT JUST KIND OF LEADS INTO WHAT IS DIFFICULT TO GET USED TO WHEN YOU GET UP THERE? BECAUSE I MEAN, IT’S A COMPLETELY ALIEN ENVIRONMENT FROM WHAT WE GROW UP AND YOU SPEND YOUR ENTIRE LIFE EXPERIENCING. WHAT’S TOUGH ABOUT IT? >> ABSOLUTELY, AND YOU KNOW, IT TOTALLY DEPENDS ON THE PERSON. AND WE CAN’T REALLY PREDICT, EVEN DEPENDING ON YOUR BACKGROUND. I COME FROM A TEST PILOT BACKGROUND, AND YOU KNOW, CAN DO THINGS IN AN AIRPLANE THAT WOULD MAKE A BILLY GOAT PUKE, BUT THAT DOESN’T MEAN THAT WHEN I GET UP HERE I’M GOING TO BE ANY BETTER THAN A SCIENTIST WHO’S NEVER BEEN IN A PLANE. IT’S NOT A GOOD PREDICTOR. I WAS LUCKY, AND WHEN I GOT UP HERE I DIDN’T HAVE CONGESTION, OR UPSET STOMACH, OR ANY OF THOSE BIG PROBLEMS THAT SOME PEOPLE DEAL WITH. BUT EVERYBODY HAS TO LEARN HOW TO FLY. AND SO AS A TEST PILOT, I WAS PROBABLY WORST THAN MOST, BECAUSE YOU KNOW, MOST PEOPLE FIND A WAY TO TRANSLATE AND FLY FROM POINT TO POINT AND JUST BE HAPPY WITH IT. BUT FOR ME, EVERY DAY I’VE GOT TO TRY SOMETHING NEW, SO I WOULD REALLY SUCK AT IT, AND RUN INTO STUFF, AND HIT MYSELF INTO THINGS. AND THAT WASN’T GOOD, BUT THEN I’D GET BETTER. AND THEN I’D TRY SOMETHING MORE OR I’D TRY GOING FASTER, AND IT WAS LIKE THIS CYCLE. SO NOW, I’M DOING PRETTY GOOD, BUT IT WAS A LONG AND BUMPY ROAD, AND DON’T ASK PEGGY HOW MANY THINGS I KNOCKED OFF THE WALL. >> OH, I MEAN, WE TALKED A LITTLE BIT EARLIER, SO YOU’VE GOT PEGGY WHITSON UP THERE-- THE SPACE NINJA, AS YOU LIKE TO CALL HER. I MEAN, ARE THERE ANY CRAZY MOVES THAT YOU’VE BROKEN OUT AND SHE’S LOOKED AT YOU AND SAID, “JACK, NO, STOP. DON’T DO THAT AGAIN.” >> OH, MY GOSH, SO MANY TIMES. SHE HAS A PATENTED LOOK. IT’S THE, “2FISH, YOU ARE CRAZY” LOOK, AND I’VE PRETTY MUCH GOT THAT DOWN. WHEN I GET THE PEGGY WHITSON “2FISH, YOU’RE CRAZY” LOOK, THEN I KNOW, OKAY, THAT ONE I’VE GOT TO STOP. >> SO I MEAN, WHAT HAVE YOU LEARNED? I MEAN, NOW YOU’VE BEEN IN SPACE WITH PEGGY WHITSON FOR THIS LONG-- WHAT HAVE YOU LEARNED FROM HER THAT YOU SORT OF TAKE WITH YOU? AND THEN I GUESS KIND OF OFF OF THAT, WHAT HAVE YOU LEARNED THAT REALLY SORT OF ANNOYS HER THAT YOU REALLY LIKE TO DO? [ LAUGHTER ] >> WELL, WE’RE LIKE TWO PEAS IN A POD. WE GIVE EACH OTHER A HARD TIME ALL THE TIME, SO WE TEASE EACH OTHER A BUNCH. WE HAVE A GOOD TIME. BUT I’M VERY-- I JUST CAN’T EVEN SAY HOW LUCKY I AM TO HAVE BEEN ON ORBIT WITH NOT ONLY PEGGY, BUT ALSO FYODOR YURCHIKHIN, MY COMMANDER AND FRIEND IN THE SOYUZ, AND THE COMMANDER OF THE STATION NOW. THOSE TWO HAVE SO MUCH EXPERIENCE THAT I LEARNED EVERYTHING FROM THEM. THEY-- YOU KNOW, NOT JUST THE BIG STUFF OF HOW TO ORGANIZE YOUR DAY AND HOW TO BE EFFICIENT AND THOSE TYPE OF THINGS, BUT EVEN THE LITTLE STUFF. AND I-- EVERY TIME THEY’RE AROUND, MY EYES ARE WIDE OPEN. YOU KNOW, HOW IS PEGGY CUTTING HER FOOD PACKET? BECAUSE IT’S PROBABLY THE BEST WAY, BECAUSE SHE’S DONE IT QUITE A FEW TIMES. SO HOW IS FYODOR HOLDING HIS CAMERA? WHAT SETTINGS IS HE USING FOR THIS TASK? TO JUST WATCH THEM AND JUST SOAK THAT IN, GOSH, I AM SO LUCKY TO HAVE BEEN UP HERE WITH THESE TWO AND JUST SOAK IN ALL THEIR GOODNESS AND KNOWLEDGE. >> AND YOU’VE BEEN WORKING SIDE BY SIDE WITH THEM FOR THE LAST COUPLE OF MONTHS. JUST WALK US THROUGH REAL QUICK WHAT’S JUST SOME OF THE STUFF YOU’RE DOING UP THERE? BECAUSE IT’S A LOT MORE THAN JUST FLYING AND STUFF LIKE THAT. YOU’RE DOING SERIOUS EXPERIMENT WORK UP THERE. >> OH, ABSOLUTELY. THE SPACE STATION IS JUST THE MOST AMAZING, WORLD-CLASS LABORATORY FLOATING AROUND, DOING SCIENCE ALL DAY, EVERY DAY. WE’RE DOING SCIENCE INSIDE. WE’RE DOING SCIENCE OUTSIDE. LET ME TURN THIS OFF REAL QUICK. I’VE GOT TO-- WE’RE GETTING AN ECHO, SO I DON’T WANT YOU TO HEAR ME TWICE-- THAT’S WAY TOO MUCH. [ LAUGHTER ] SO THE SPACE STATION-- FOR EXAMPLE, WHEN SPACEX 11 CAME UP, IT HAD 6 TONS OF SCIENCE, MOSTLY SCIENCE ONBOARD, THAT THEN WE HAD TO BRING ONBOARD, KNOCK OUT THAT SCIENCE, GET IT BACK ON THE SPACEX AND BACK TO EARTH. THAT’S THE JOB OF THIS PLACE, IS JUST ROCKING THE SCIENCE. WE’RE DOING NOT ONLY STUFF FOR HUMAN HEALTH AND THOSE TYPE OF SCIENCES-- THERE WAS A GREAT EXPERIMENT THAT PEGGY WAS WORKING ON THE OTHER DAY WITH A NEW DRUG THAT ACTUALLY FINDS, TARGETS CANCER CELLS. WE’RE GROWING LUNG CANCER TISSUE, AND IT WAS DOING SOME GREAT WORK AGAINST THE CANCER. HOW COOL WOULD THAT BE IF WE COULD CRACK THE CODE OF THAT HORRIBLE DISEASE THAT EVEN MY DAUGHTER FELL PREY TO? SO NOT JUST THOSE-- WE’RE LOOKING-- JUST TEN FEET FROM ME IS A MACHINE CALLED THE ELF THAT’S LOOKING AT NEW WAYS TO CREATE ALLOYS THAT ARE LIGHTER, THAT ARE STRONGER. I MEAN, THIS WHOLE PLACE, EVERY SQUARE INCH IS DEDICATED TO EITHER PURE SCIENCE OR THE SYSTEMS THAT ARE GOING TO KEEP US AND THOSE SCIENCE EXPERIMENTS CRANKING AWAY AND GETTING GREAT RESULTS BACK TO EARTH TO HELP HUMANITY, TO MAKE HUMANITY BETTER, AND TO ENABLE US TO EXPLORE AND GO FURTHER INTO THE UNIVERSE. >> THAT SOUNDS INCREDIBLE. I’M SURE-- I MEAN, BESIDES ALL THE SCIENCE, YOU HAVE A LOT OF-- I GUESS-- I DON’T KNOW ABOUT A LOT OF CHANCES, BUT YOU DO HAVE THE CHANCE TO SORT OF LOOK OUT THE WINDOW AND SEE THE EARTH GO BY. SO WE DO HAVE A FACEBOOK QUESTION FROM [ INDISTINCT ]: “HOW DO WE LOOK FROM ORBIT?” I DON’T KNOW IF YOU’RE-- WHENEVER YOU’RE TAKING PICTURES OF THE EARTH, I DON’T KNOW IF YOU CAN ACTUALLY ZOOM DOWN AND GET SO CLOSE THAT YOU CAN START TO SEE PEOPLE OR ARE YOU THAT FAR UP? >> WELL, WE’RE PRETTY FAR UP. IF WE HAD A BIGGER LENS, WE COULD PROBABLY SEE YOU, BUT THE BIGGER THE LENS, THE SMOOTHER YOU HAVE TO BE. FYODOR COULD PROBABLY DO IT-- I CAN’T DO IT. SO THE BIGGEST THAT I’VE BEEN USING IS AN 800 MILLIMETER LENS, AND WE CAN GET ABOUT TO HOUSES AND SEE HOUSES. SO THAT’S ABOUT AS FINE DETAIL AS WE CAN SEE. SO WE’RE NOT LOOKING IN YOUR WINDOW AND SPYING ON YOU, I PROMISE. [ LAUGHTER ] >> WELL, THAT’S GOOD TO KNOW, BUT I’M SURE-- I MEAN, YOU SEE-- YOU’RE TRAVELLING SO FAST AROUND THE EARTH, YOU GET TO SEE SO MUCH OF IT. IS THERE ANY SORT OF PLACES ON EARTH THAT REALLY STAND OUT TO YOU THAT YOU REALLY LIKE TO EITHER GAZE AT OR KIND OF TAKE PICTURES OF? BECAUSE YOU SEE SO MUCH OF IT IN A SHORT PERIOD OF TIME. >> YOU BET. THERE ARE PLACES THAT KIND OF BLEW ME AWAY FOR SURE THE FIRST TIME I SAW THEM. THE BAHAMAS ARE JUST-- THE BLUE IS JUST RIDICULOUS. I DON’T EVEN KNOW-- IT’S HARD TO BELIEVE IT’S REAL. ONE OF FYODOR’S FAVORITE PLACES IS KAMCHATKA, WHICH IS KIND OF A LITTLE PHALANGE OFF THE TOP END OF RUSSIA. THERE’S ALL THESE GREAT VOLCANOES THAT ARE JUST INCREDIBLE LOOKING. SO THERE’S A LOT OF PLACES THAT ARE WONDERFUL, BUT WHAT I’VE REALLY TRY TO DO, AND IT’S PROBABLY WHY I DON’T HAVE PICTURES OF SPECIFIC PLACES LIKE MY HOMETOWN IN COLORADO, LOUISVILLE, OR THOSE PLACES, IS BECAUSE I KIND OF GO TO THE WINDOW AND LET GOD SHOW ME WHAT-- SHOW ME THE TOUR AND I’VE NEVER BEEN DISAPPOINTED. YOU COULD BE FLYING OVER THE SAHARA AND YOU’LL SEE THESE BRIGHT REDS AND A MOUNTAIN RIGHT NEXT TO SAND, OR A SANDSTORM, AND THEN YOU’LL BE IN THE HIMALAYAS AND YOU’LL SEE THESE INCREDIBLE MOUNTAINS. EVERY TIME I LOOK OUT THE WINDOW I’M JUST IN AWE AT HOW BEAUTIFUL THE EARTH IS. SO MY FAVORITE PLACE-- EARTH. >> GOOD ANSWER. ALL RIGHT, WELL, YOUR ACROBATICS ARE MAKING A LOT OF PEOPLE JEALOUS AND WE’RE ACTUALLY GETTING IN A LOT OF QUESTIONS ABOUT HOW TO BECOME AN ASTRONAUT, SO I WANT TO SWITCH GEARS REAL QUICK. SO WE’VE HAD A LOT OF NEWS, A LOT OF STUFF OUT THERE. WE JUST HIRED A NEW GROUP OF ASTRONAUTS-- OR A NEW ASTRONAUT IN CANADA SAID THEY’RE GOING TO BE REPORTING SOON. AND ONE OF MY FAVORITE THINGS TO TALK TO THEM ABOUT WAS WHEN THEY GOT THE CALL, WHEN THEY GOT THE CALL THAT THEY’RE GOING TO COME BE AN ASTRONAUT. BUT I DON’T KNOW IF YOU REMEMBER, BUT I WAS ACTUALLY WITH YOU SHORTLY AFTER YOU GOT THE CALL THAT YOU HAD GOT-- YOU HAD GOTTEN ASSIGNED TO A MISSION.. SO I HAVE TO ASK, WHICH ONE WAS MORE EXCITING, YOU’RE GOING TO BE AN ASTRONAUT, OR, “HEY, IT’S TIME TO GO FLY IN SPACE”? >> BOY, THAT’S TOUGH. PROBABLY THE “YOU’RE GOING TO BE AN ASTRONAUT” NOT BECAUSE YOU TAKE IT FOR GRANTED THAT YOU’LL FLY, BUT IT’S JUST ONCE YOU’RE AN ASTRONAUT YOU GOT A REAL GOOD CHANCE THAT YOU’RE GOING TO FLY. BEFORE THAT, AND TO BECOME AN ASTRONAUT, WHEN PEOPLE ASK, “HOW DO YOU BECOME AN ASTRONAUT?” WELL, I’LL GIVE YOU THE ADVICE THAT MY DAD GAVE, “DARE TO DREAM.” SO ONLY YOU CAN DEFINE YOUR OWN DREAM, TO FIND YOUR PASSION, THE THING THAT REALLY MAKES YOU GO, BECAUSE ONCE YOU FIND THAT YOU’RE GOING TO WORK HARD AT IT, AND THAT’S WHAT THE DARE PART IS. NOBODY’S GOING TO GIVE IT TO YOU. YOU GOT TO WORK REALLY HARD TO MAKE THAT PASSION AND THAT DREAM A REALITY. BUT THEN, THERE’S ONE MORE PART OF IT, AND TO BECOME AN ASTRONAUT ONE OF THE BIGGEST PARTS OF IT IS JUST SHEER LUCK, TIMING, AND I AM JUST LUCKY. THERE ARE TONS OF PEOPLE MORE QUALIFIED THAN ME THAT ARE BETTER THAN ME IN EVERY SINGLE WAY, BUT MAYBE THAT ROUND OF INTERVIEWS THEY DIDN’T APPLY OR THEY WEREN’T IN THE RIGHT PLACE IN THEIR LIFE THAT THEY COULD APPLY. I JUST GOT LUCKY TO BE IN THE RIGHT PLACE AT THE RIGHT TIME AND BE A PART OF AN INCREDIBLE GROUP. SO MY ADVICE FOR PEOPLE WHO WANT TO BECOME AN ASTRONAUT, FIND YOUR PASSION SO THAT YOU NEVER WORK A DAY IN YOUR LIFE, WORK REALLY HARD AT IT, AND THEN EVEN IF IT DOESN’T WORK OUT BECAUSE YOU WEREN’T LUCKY AT THE RIGHT TIME TO BE SELECTED AS AN ASTRONAUT YOU’RE STILL DOING WHAT YOU LOVE AND YOU’RE MAKING A BIG DIFFERENCE ON THIS PLANET. >> WELL, JACK, I DON’T THINK YOU GIVE YOURSELF ENOUGH CREDIT. I THINK, LIKE, YOU’RE AN EXTREMELY HARD WORKER AND YOUR PASSION IS DEFINITELY REFLECTED ON EVERYTHING THAT YOU DO. ESPECIALLY US, WE REALLY ENJOY WATCHING YOU ON ORBIT. BUT FOR FOLKS WHO WANT TO BECOME AN ASTRONAUT YOU CAN ACTUALLY GIVE THEM A SENSE OF SORT OF WHAT THAT FEELS LIKE. AND I KNOW THERE’S A LOT OF-- THERE’S A LOT OF HARD WORK AND A LOT OF DIFFERENT THINGS YOU HAVE TO LEARN, BUT THERE’S ALSO THAT ELEMENT-- THE HUMAN ELEMENT OF BEING IN SPACE, OF LIVING IN SPACE. SO I HAVE A QUESTION JUST ABOUT, DO YOU EVER FEEL ISOLATED? DO YOU EVER FEEL AWAY FROM THINGS? OR ARE YOU SORT OF CONNECTED? AND THEN, I HAVE ANOTHER QUESTION FROM FACEBOOK FROM KAY, ASKING IF YOU HAVE INSOMNIA IN SPACE? THERE TWO SORT OF RELATED QUESTIONS, NOT REALLY, BUT THAT FEELING OF BEING IN SPACE. [ LAUGHING ] >> OKAY, I’M GOING TO HAVE TO FLIP MID QUESTION BECAUSE THAT’S REALLY TWO QUESTIONS. >> YEAH, YEAH. >> SO I’LL DO THE FIRST ONE QUICKLY. THE INSOMNIA ONE, SOME PEOPLE HAVE A HARD TIME SLEEPING IN SPACE, I DON’T. MY BACK USUALLY KIND OF HURTS ON THE GROUND BECAUSE I’VE BEEN FLYING FIGHTERS FOR TOO LONG, BUT UP HERE, I FEEL GREAT. SO IT’S LIKE SLEEPING ON AN AIRBED BECAUSE, WELL, I’M FLOATING ON AIR, SO THAT’S AWESOME, OKAY? NOW, I GOT TO FLIP. ISOLATED-- YOU DO FEEL A BIT, NOT BECAUSE THERE’S NOT CONNECTIVITY WITH THE GROUND. WE CAN CALL VIA AN INTERNET PROTOCOL PHONE, AS WELL AS VIDEO CHAT SOMETIMES, AND THEN WE’RE IN CONSTANT COMMUNICATION WITH THE GROUND ALL THROUGHOUT THE DAY. AS FAR AS FEELING ISOLATED, SOMETIMES YOU FEEL BECAUSE EVERYTHING YOU’RE DOING IS BEING WATCHED-- AND I’M NOT TALKING ABOUT A PODCAST OR POSTING ON TWITTER OR ANY OF THOSE TYPE OF THINGS. EVERYTHING WE DO AS WE’RE DOING SCIENCE AND AS WE’RE DOING ACTIVITIES IS BEING WATCHED BY THE CONTROL CENTERS WORLDWIDE THAT ARE KEEPING THIS PLACE RUNNING. AND SO, YOU CAN KIND OF FEEL LIKE, “MY, GOSH!” BECAUSE YOU’RE GOING TO MAKE MISTAKES. YOU CAN’T GO FOR SIX MONTHS DOING 12 HOURS A DAY AND NOT MAKE MISTAKES. YOU’RE GOING TO MAKE MISTAKES AND SOMETIMES YOU FEEL LIKE, “MAN, EVERYBODY IS SEEING EVERYTHING THAT I’M DOING WRONG.” LIKE, YOU HAVE A BAD DAY. THAT’S WHEN I BREAK INTO MY EMERGENCY COFFEE STORE AND GET ANOTHER COFFEE POUCH OUT SO I CAN HAVE SOME COFFEE AND THEN THINGS GET BETTER. >> ALL RIGHT. WE ONLY GOT A COUPLE OF MINUTES LEFT SO IT’S TIME TO GET INTO SOME OF THE DEEP STUFF, THE DEEP CUTS HERE. SO, YOU’VE BEEN UP THERE FOR A COUPLE OF MONTHS, HAS JUST YOUR PERSPECTIVE ABOUT EVERYTHING-- ABOUT LIFE ON EARTH, ABOUT LIFE IN GENERAL, ABOUT YOUR JOB, ABOUT ALL OF THAT-- HAS BEING IN SPACE CHANGED THAT? LIKE, DO YOU HAVE THE OVERVIEW EFFECT YET? >> YOU KNOW, YOU DO, BECAUSE YOU GET TO SEE THE WORLD IN THIS TOTALLY DIFFERENT LIGHT, THIS WORLD WITHOUT BORDERS. ONE SHARED EXPERIENCE FOR EVERYBODY, AND THE BEAUTY, AND JUST THAT THIN BLUE LINE THAT IS SO FRAIL THAT HOLDS ALL OF LIFE. YOU JUST-- YOUR PERSPECTIVE HAS TO GROW, AND ADAPT, AND CHANGE TO THAT. BUT LIKE I MENTIONED EARLIER, HOW QUICKLY YOUR BRAIN ADAPTS AND GROWS, I THINK THAT PERSPECTIVE HELPS YOU GROW AS WELL. AND THAT’S WHY AFTER THIS EXPERIENCE, YES, MY PERSPECTIVE HAS CHANGED, BUT IT IS REALLY INSPIRED ME TO TRY TO GET MORE PEOPLE THIS EXPERIENCE AND TO GET A PERMANENT FOOTHOLD IN THE STARS FOR OUR SPECIES. I THINK WE’RE ON THE VERGE OF THAT. AND WITH ORION AND SLS, OUR NEW HUGE ROCKET, WE’RE TAKING STEPS TOWARDS THAT, AS WELL AS THE COMMERCIAL INDUSTRY, A BURGEONING COMMERCIAL INDUSTRY, THAT’S BUILDING THE INFRASTRUCTURE FOR US TO PRESS FURTHER INTO THE GALAXY. SO I’M-- MY PERSPECTIVE CHANGE IS THAT I WANT TO DO EVERYTHING I POSSIBLY CAN TO HELP THE HUMAN SPECIES, HUMANITY AS A WHOLE, GO FURTHER AND GROW AND EVOLVE LIKE I KNOW THEY’RE CAPABLE OF. >> AMAZING. THAT’S-- IT’S JUST SUCH AN INCREDIBLE PERSPECTIVE. I MEAN, JUST-- I MEAN, LOOKING DOWN AND JUST REALIZING KIND OF WHAT WE CAN ACCOMPLISH, IT’S KIND OF AMAZING. BUT I GUESS FROM THERE, DO YOU EVER-- DO YOU EVER SORT OF MISS EARTH? OR MAYBE EVEN I GUESS HERE’S A QUESTION FROM GERALD DEAN, “DO YOU EVER MISS GRAVITY?” >> OH, SOMETIMES. THE OTHER DAY I WAS DOING A TASK AND MY WRENCH, LIKE, POPS OFF THE BOLT AND IT GOES FLYING OFF, AND I’M LIKE, “OH, NO BIG DEAL. IT’LL HIT THE WALL AND COME BACK TO ME.” AND I LOOK OVER AND THERE’S THIS GAP ABOVE THE RACK, AND IT’S LIKE-- IT’S LIKE AN INCH. AND THAT WRENCH DECIDED, “OH, I’M GOING TO TURN SO I’M PERFECTLY IN LINE WITH THAT GAP.” AND IT WENT FLOATING INSIDE AND THEN IT WAS BEHIND THE RACK AND LOST FOREVER. PROBABLY IN LIKE TWO YEARS, SOMEBODY’S GOING TO BE CLEANING AN AIR VENT AND GO, “OH, HEY, LOOK, A WRENCH. I WONDER WHERE THAT CAME FROM.” SO, THERE ARE SOME TIMES YOU REALLY MISS GRAVITY, BUT ABOUT 99.9% OF THE TIME YOU DON’T. >> ALL RIGHT, WELL, I MEAN, FIRST OFF, I JUST WANT TO SAY I FULLY SUPPORT YOUR NEW PERSPECTIVE BECAUSE I WANT TO GO TO SPACE, SO, JACK, DO EVERYTHING YOU CAN TO GET ME UP THERE. SO, YOU’RE GETTING CLOSE TO COMING HOME. YOU’RE COMING HOME THE BEGINNING OF SEPTEMBER. IS THERE ANYTHING LEFT ON THE LIST THAT YOU WANT TO DO WHILE YOU’RE UP THERE? IS THERE LIKE A SPACE BUCKET LIST BEFORE YOU COME BACK? >> THERE IS, AND THERE’S-- IT’S SUCH A HUGE LIST, YOU CAN KIND OF GET OVERWHELMED BY IT. I WANT A PICTURE OF THIS, OR THAT, OR-- I’VE MADE A LIST AND I SAID, “I’M NOT GOING TO ADD ANYTHING ELSE TO IT. “SO, I’M ALMOST THROUGH IT, AS FAR AS THE STUFF I WANT TO TAKE PICTURES OF OR RECORD OR GRAB. AND THEN, I’M GOING TO TAKE ALL OF MY SPARE TIME AND JUST GO DOWN AND GRAB A WINDOW OR WHATEVER AND SIT THERE AND SOAK IT UP AND JUST ENJOY IT AND TAKE A MENTAL IMAGE SO THAT I CAN FUEL THAT PASSION. AND WHEN I COME BACK TO TRY TO TALK TO PEOPLE AND GET THEM EXCITED ABOUT SPACE, IT-- THERE’S A BIG OLD WELL OF PASSION INSIDE ME BECAUSE I JUST SAT THERE AND PLUGGED INTO THE INSPIRATION BAR IN THE CUPOLA. YOU LOOK OUT, ESPECIALLY-- NOT JUST DOWN AT EARTH BUT OUT TOWARDS THE STARS, AND IT CAN’T HELP BUT MAKE YOU SO EXCITED THAT THERE’S SOMETHING ELSE OUT THERE THAT WE’RE GOING TO GO, AND EXPLORE, AND I CAN’T WAIT. >> WOW. JUST, JACK, THIS HAS BEEN SUCH AN INCREDIBLE FEW MINUTES WITH YOU. THANK YOU SO MUCH FOR ACTUALLY TAKING THE TIME TO TALK WITH US, AND TO ANSWER SOME QUESTIONS FROM FACEBOOK LIVE, AND TO SPEND THIS TIME WITH US. HONESTLY, THIS IS ONE OF THE BEST EXPERIENCES OF MY LIFE. IF I HAD TO PIN IT INTO A PHRASE, AND THIS IS JUST OFF THE TOP OF MY HEAD, I’D PIN IT AS SOMETHING LIKE A TRIPLE DECKER, FULLY LOADED BURGER OF AWESOME, BETWEEN TWO PERFECTLY TOASTED AWESOME BUNS. >> NAILED IT. NAILED IT. >> AND THAT’S-- THAT’S JUST OFF THE TOP OF MY HEAD. BUT AGAIN, THANK YOU SO MUCH FOR SPENDING THIS TIME WITH ME, AND BEST OF LUCK TO YOU ON THE REST OF YOUR MISSION. >> WELL, THANKS A LOT. I’LL TRY TO SAY GOODBYE WHILE I’M SPINNING. IF I RUN INTO SOMETHING YOU CAN LAUGH. BUT THANK YOU FOR LETTING ME BE A PART OF THIS AND I HOPE EVERYBODY THAT’S IN THE PODCAST UNIVERSE HAD A GREAT TIME. PLEASE, IF YOU GET EXCITED ABOUT SPACE, NASA.COM. WE HAVE SO MANY RESOURCES, SO MANY WAYS THAT YOU CAN GET ENGAGED, WHETHER YOU’RE A TEACHER, A STUDENT, JUST A GUY ON THE STREET, PLEASE CHECK IT OUT. >> WOW. SO INCREDIBLE. >> STATION, THIS IS HOUSTON ACR, THAT CONCLUDES THE EVENT. >> THANK YOU ALL PARTICIPANTS WITH JSC PAO. WE’RE NOW RESUMING OPERATIONAL COMM. >> ALL RIGHT. WOW. >> OH, MAN. >> SO, WE JUST TALKED TO SOMEBODY IN SPACE. >> THAT WAS REALLY COOL. >> THAT WAS REALLY COOL, RIGHT. HOW COOL IS THAT? >> WOW. I JUST-- I REALLY JUST APPRECIATE HIS ENERGY, YOU KNOW? >> OH, YEAH. >> JUST THE LIFE THAT HE ADDS. IT’S NOT JUST LIKE A CONVERSATION, “THIS IS WHAT I’M DOING.” >> YEAH. >> NO, HE’S TRULY PASSIONATE ABOUT BEING IN SPACE AND PRESSING FORWARD ON NASA’S MISSION, IT TOTALLY COMES ACROSS IN EVERYTHING HE DOES. >> HE IS. IT’S JUST-- IT’S STILL SURREAL, BECAUSE I MEAN, WE’RE-- FOR EVERYBODY WATCHING, YOU CAN SEE WE’RE-- WE WERE LOOKING AT JACK ON A TV. >> YEAH. >> I MEAN, IT LOOKS LIKE HE’S FIVE FEET AWAY FROM US. >> RIGHT. >> WHEN IN REALITY, HE’S PROBABLY ON THE OTHER SIDE OF THE PLANET RIGHT NOW, FLYING AROUND. LIKE, HERE WE ARE TALKING TO HIM, SO I-- IT’S SO COOL. >> OH, WOW. >> AND WAY TO NAIL THAT CLOSING-- WAY TO NAIL THE GOODBYE, GARY. I’M VERY PROUD OF YOU. >> IT WAS JUST OFF THE TOP OF MY HEAD. >> JUST THE TOP OF YOUR HEAD. >> AWESOME. WELL, HONESTLY, YOU CAN-- SO, EVERYTHING-- HONESTLY, JACK IS A REALLY COOL PERSON TO FOLLOW ON SOCIAL MEDIA. >> YES. >> IF YOU EVER GO ON FACEBOOK, TWITTER, OR INSTAGRAM, WHICH YOU SHOULD, FOLLOW @ASTRO2FISH. THAT’S HIS-- THAT’S HIS HANDLE, RIGHT. HE SHARES ALL THESE DIFFERENT PHOTOS OF WHAT HE’S DOING, ALL THE EXPERIMENTS HE’S DOING, PHOTOS OF EARTH, AND HE’S JUST SUPER ENGAGED IN THE MISSION. YOU CAN SEE EVERYTHING HE’S DOING THERE. REALLY AN INCREDIBLE THING TO FOLLOW. IF YOU JUST WANT TO FOLLOW EVERYTHING ON THE INTERNATIONAL SPACE STATION WE HAVE THOSE TOO, @ISS, I THINK IS-- OR @SPACE_STATION. >> YEAH, THERE’S A WHOLE BUNCH OF DIFFERENT SITES YOU CAN FOLLOW. AS HE SAID, IT’S NASA.GOV FOR PRETTY MUCH EVERYTHING NASA’S DOING. >> YEAH. >> AND IF YOU’RE INTERESTED IN THE SPACE STATION, IT’S NASA.GOV/ISS. WE’RE ALL ACROSS SOCIAL MEDIA-- FACEBOOK, TWITTER, AND INSTAGRAM. THOSE NAMES ARE ALL A LITTLE BIT DIFFERENT, BUT IT’S ALL RELATED TO THE SPACE STATION. AND WE ALWAYS LIKE TO GET QUESTIONS ON EVERYTHING, SO USE #ASKNASA AND WE’LL TO AS MANY AS WE CAN. AND SINCE I DON’T WANT TO MAKE GARY DO HIS OWN SHAMELESS PLUG, “HOUSTON, WE HAVE A PODCAST.” IT’S INCREDIBLE. IF YOU’RE EVER WANTING TO GO BEHIND THE SCENES WITH THE PEOPLE THAT MAKE HUMAN SPACE FLIGHT HAPPEN, THAT’S WHERE YOU GET IT. YOU GET THE DEEP DIVES, YOU GET THE EXPERTS, YOU GET THE FULL THING, AND I OCCASIONALLY GET TO COME IN AND DO FUN STUFF LIKE THIS, SO IT’S A BLAST. >> IT’S TRUE. WE’VE TALKED TO SOME REALLY COOL PEOPLE SO FAR, YOU BEING ONE OF THEM, OF COURSE, DAN. BUT ALSO-- >> I WAS THE GUINEA PIG. >> BUT WE HAVE TALKED TO THREE ASTRONAUTS SO FAR. WE HAVE JUST-- JACK FISCHER TODAY, BUT ALSO RANDY BRESNIK, WHO’S UP IN SPACE RIGHT NOW, AND WE ALSO GOT TO TALK TO SHANE KIMBROUGH, LIKE, TWO DAYS AFTER HE LANDED AND HE GAVE THAT WHOLE EXPERIENCE. BUT THEN WE TALK ABOUT THE SCIENCE, WE TALK ABOUT SPACE FOOD, WE GOT A LOT MORE COOL EPISODES COMING UP SO STAY TUNED. YOU CAN FIND ALL OF THOSE ON iTUNES SOUNDCLOUD AND NASA.GOV, LIKE DAN SAID. SO I THINK THAT’S GOING TO WRAP UP, UNLESS THERE’S ANYMORE QUESTION-- WELL, I’M SURE THERE’S A LOT OF QUESTIONS, BUT WE’LL SAVE THOSE FOR-- ACTUALLY, YOU COULD TWEET #ASTRO2FISH. HE MIGHT ANSWER A COUPLE OF THOSE FOR YOU. AWESOME. WELL, THANK YOU SO MUCH FOR TUNING IN TODAY FOR THE FIRST LIVE RECORDING OF “HOUSTON, WE HAVE A PODCAST.” THAT’LL DO IT FOR US HERE AND HOPE YOU KEEP LISTENING TO US IN THE FUTURE. IF YOU HAVE ANY SUGGESTIONS ON WHAT WE SHOULD PUT ON THE SHOW, PUT IT IN THE COMMENTS OR USE THE HASHTAG #ASKNASA. THANKS SO MUCH. [ MUSIC ] >> HOUSTON, GO AHEAD. >> I’M ON THE SPACE SHUTTLE. >> ROGER, ZERO-G AND I FEEL FINE. >> SHUTTLE HAS CLEARED THE TOWER. >> WE CAME IN PEACE FOR ALL MANKIND. >> IT’S ACTUALLY A HUGE HONOR TO BREAK THE RECORD LIKE THIS. >> NOT BECAUSE THEY ARE EASY, BUT BECAUSE THEY ARE HARD. >> HOUSTON, WELCOME TO SPACE. >> HEY, THANKS FOR STICKING AROUND. SO, WE ALREADY KIND OF PLUGGED EVERYTHING THAT WE NEEDED TO PLUG. WE TALKED ABOUT WHERE YOU CAN FOLLOW JACK FISCHER, WHERE YOU CAN FOLLOW THE INTERNATIONAL SPACE STATION, ASK QUESTIONS, DO ALL THAT KIND OF STUFF. SO THE ONLY THING I’LL ADD IS THAT THIS PODCAST WAS RECORDED ON AUGUST 10th, 2017. THANKS TO ALEX PERRYMAN, JOHN STOLL, TOMMY GRESIK, PAULA VARGAS, CHARLES GLENN-DANIEL, GREG WISEMAN, ROB NAVIAS, AND OF COURSE DAN HUOT. THANKS AGAIN TO COLONEL JACK FISCHER FOR COMING ON THE SHOW. WE’LL BE BACK NEXT WEEK.